title: Migration of rod through skull, into brain following C1-C2 instrumental fusion for os odontoideum: a case report.
abstract: METHODS
  Case report and brief literature review.
  
  
  OBJECTIVE
  To describe a unique complication following C1/2 fusion in a pediatric patient.
  
  
  BACKGROUND
  Os odontoideum, if symptomatic or unstable, should be treated by internal fixation. Posterior instrumented fusion of the cervical spine is not an uncommon surgical procedure.
  
  
  METHODS
  Direct observation and management of the patient during representation with postoperative complication.
  
  
  RESULTS
  This case report details the previously unrecorded and unusual migration of a fixation device through the skull into the brain and outlines its subsequent removal.
  
  
  CONCLUSIONS
  Failure of bony fusion can result in micromotion and subsequent migration of fixation device components. This can occur even if the screw fixation is apparently sound. Extended routine radiographic follow-up would identify migration earlier.
authors.affiliation: Dubbo Base Hospital, New South Wales, Australia. jgap@hotmail.com
authors.forename: James George Arthur
authors.initials: JG
authors.lastname: Plant
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ruff
mesh_terms: D000293:Adolescent; D001863:Bone Screws / Q000009:adverse effects*; D001921:Brain / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D002648:Child; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation