title: An Incidental Finding of a Radiopaque Pill following Cervical Spinal Surgery in a Parkinson's Disease Patient.
abstract: There are previous reports of the identification of radiopaque medications on abdominal X-rays or computed tomography (CT). We describe an interesting case of the incidental identification of a radiopaque medication on cervical spinal CT following cervical spinal surgery. A sixty seven-year-old male patient with Parkinson's disease (PD) visited our emergency center with a C5-6 dislocation and fracture. Surgery was performed with open reduction and pedicle screw fixation through the posterior approach. No abnormal events occurred during the perioperative period. However, a radiopaque incidental foreign body in front of the C6 vertebrae was found on a cervical spinal CT and X-rays that were performed as routine examinations on postoperative day 3. After 6 hours, we performed gastrofibroscopy (GFS) but were unable to find anything. Therefore, we checked all of his medications related to the neck and check X-ray again. One enteric-coated pill he had taken exhibited strong radiodensity. Although our patient underwent an unnecessary GFS, every spinal surgeon should keep in mind that radiopaque pills can appear similar to spinal instruments on X-ray and CT. In addition, we should also know the associated dysphagia is a possible cause of the delayed passage of medicine in PD with or without cervical osteophytes.
authors.affiliation: Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Bon Sub
authors.initials: BS
authors.lastname: Gu
authors.affiliation: Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Soo-Jung
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Byoungwoo
authors.initials: B
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Koon Hee
authors.initials: KH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Jong Kyu
authors.initials: JK
authors.lastname: Park
authors.affiliation: Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Young-Seok
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangwon-do, Korea.
authors.forename: Jin Hoon
authors.initials: JH
authors.lastname: Park
keywords: Dislocations; Foreign bodies; Gastroscopy; Parkinson's disease; X-Rays