Dislodged upper thoracic cage in the gastrointestinal tract: a case report and literature reviews.
METHODS
A rare case of esophageal perforation secondary to a dislodged upper thoracic cage found by the gastrointestinal endoscope is presented.


OBJECTIVE
To report an extremely rare complication of upper thoracic vertebral tuberculosis treated with corpectomy and interbody cage surgery and suggest the cause, mechanism, and outcome of the complication of esophageal perforation.


BACKGROUND
Tuberculotic spondylitis often affects the anterior column of the spine and surgery is indicated in the presence of an epidural abscess, neurologic deficits secondary to compression of the spinal cord, bone destruction with instability, or failure of antituberculous therapy. Surgical treatment requires radical debridement followed by anterior stabilization. A controversy exists regarding the use of the instrumentation in the tuberculous spine.


METHODS
Retrospective case study and literature review.


RESULTS
Because of the concomitant medical problems and little deterioration of the neurologic function, our patient is managed uneventfully with conservative treatment.


CONCLUSIONS
To the authors' knowledge, this is an extremely rare reported complication of upper thoracic cage surgery for vertebral tuberculosis. This case demonstrates that the cage migration in the tuberculous spondylitis might have a rather benign clinical course and structural bone grafting or interbody cage insertion without supplemental instrument fixation seems to be inadequate.
Chen
Chiu-Liang
CL
Department of Orthopedic Surgery, Changhua Christian hospital, Changhua City, Taiwan. 111111@cch.org.tw
Chou
Chii-Wen
CW
Su
Wei-Wen
WW
Cheng
Ching-Yuan
CY
Yu
Chen-Tung
CT
D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D019736:Prostheses and Implants / Q000009:adverse effects*; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery