title: Rod Migration to the Thoracic Subarachnoid Space after C1-2Instrumentation: A Case Report and Literature Review.
abstract: Posterior instrumented fusion of the cervical spine is a common surgical procedure in the treatment of cervical subluxation, fractures, and stenosis. Although malpositions are commonly seen, it is rare to observe the malposition of the rod or interconnection because of hardware failure. A 62-year-old woman with spastic tetraparesis as a sequel to pediatric meningitis with C1-C2cervical subluxation and myelomalacia had undergone laminectomy of C1and C1lateral mass and C2bilateral pedicular screw fixation. Three years after the stabilization, she presented with complaints of headache, neck pain, and difficulty walking. There was no history of trauma during that period. A previously unrecorded and unusual migration of a rod through the thoracic subarachnoid space was detected. In this study, we report a case of atlantoaxial stabilization using the screw-rod technique that was followed by rod migration to the thoracic subarachnoid space, and outline the subsequent management of the case. Failure of bony fusion can result in micromotion and subsequent migration of fixation device components. Routine radiographic follow-up could be used to identify migration events.
authors.affiliation: Department of Neurosurgery, Uludag University Medical School, Bursa, Turkey.
authors.forename: Seref
authors.initials: S
authors.lastname: Dogan
authors.affiliation: Department of Neurosurgery, Uludag University Medical School, Bursa, Turkey.
authors.forename: Elif Basaran
authors.initials: EB
authors.lastname: Gundogdu
authors.affiliation: Department of Neurosurgery, Uludag University Medical School, Bursa, Turkey.
authors.forename: Mevlüt Özgür
authors.initials: MÖ
authors.lastname: Taşkapılıoğlu
authors.affiliation: Department of Neurosurgery, Uludag University Medical School, Bursa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karaoglu
mesh_terms: D001268:Atlanto-Axial Joint / Q000601:surgery; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D013346:Subarachnoid Space / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Atlantoaxial stabilization; Cervical stabilization; Complication; Migration; Posterior cervical stabilization