title: Rod Migration Into the Spinal Canal After Posterior Instrumented Fusion Causing Late-Onset Neurological Symptoms.
abstract: BACKGROUND
  Rod migration into the spinal canal after posterior instrumented fusion is a rare complication causing late-onset neurological symptoms. The purpose of the present study is to report a case of a 13-year-old boy with spastic cerebral palsy and related neuromuscular kyphoscoliosis who developed late-onset neurological deterioration secondary to progressive implant migration into the spinal canal over a 5-year period.
  
  
  METHODS
  A decision was made to remove both rods to achieve decompression. Intraoperative findings were consistent with information gained from preoperative imaging. The rods were found to have an intracanal trajectory at T9-T10 for the right rod and T12-L2 for the left rod.
  
  
  RESULTS
  The cause of implant migration, with progressive laminar erosion slow enough to generate a solid mass behind, was progressive kyphosis in a skeletally immature patient with neuromuscular compromise.
  
  
  CONCLUSIONS
  Fixation type, early surgery, and spasticity management contributed significantly to the presenting condition. Mechanical factors and timing of surgery played a decisive role in this particular presentation.
  
  
  METHODS
  Level IV--Case report and review of the literature.
authors.affiliation: *University Hospital Estaing, Pediatric Surgery Department, Clermont-Ferrand †St. Odilon Hospital, Orthopedic Surgery Department, Moulins ‡University of Montpellier, Faculty of Medicine, Montpellier §Académie Nationale de Médecine, Paris, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Canavese
authors.forename: Petru
authors.initials: P
authors.lastname: Dmitriev
authors.forename: Jacques
authors.initials: J
authors.lastname: Deslandes
authors.forename: Antoine
authors.initials: A
authors.lastname: Samba
authors.forename: Alain
authors.initials: A
authors.lastname: Dimeglio
authors.forename: Mounira
authors.initials: M
authors.lastname: Mansour
authors.forename: Marie
authors.initials: M
authors.lastname: Rousset
authors.forename: Jean
authors.initials: J
authors.lastname: Dubousset
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications*; D020878:Device Removal / Q000379:methods*; D006801:Humans; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011475:Prosthesis Failure / Q000009:adverse effects / Q000209:etiology; D012086:Reoperation; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D013115:Spinal Canal / Q000000981:diagnostic imaging*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome