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脊柱前路杆从胸腰椎迁移至膝关节:脊柱器械的一种不常见并发症。

Migration of anterior spinal rod from the dorsolumbar spine to the knee: an unusual complication of spinal instrumentation.

机构信息

Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Spine (Phila Pa 1976). 2010 Apr 1;35(7):E270-2. doi: 10.1097/BRS.0b013e3181c5d4da.

Abstract

STUDY DESIGN

A retrospective case report.

OBJECTIVE

The objective of the present article is to report an unusual complication of spinal instrumentation.

SUMMARY OF BACKGROUND DATA

Migration of spinal implants to distant site is quite unusual, and literature till date has only 2 case reports. For the first time, we are reporting a case of anterior spinal rod migration from the dorsolumbar spine to the knee joint in a young male patient after 4 years of its fixation following spinal injury.

METHODS

A 38-year-old man presented with pain, swelling, and restriction of movement of left knee joint. On clinical examination, a hard movable rod was palpable which was suspected to be a metallic foreign body initially. The detailed history of the patient revealed anterior spinal fixation following posttraumatic injury of L1 vertebra 4 years back. Radiograph showed a metallic rod lying around the knee joint with absence of anterior rod of dorsolumbar spine. The suspicion of migration of the rod was confirmed by surgical exploration.

RESULTS

After 1 week of removal of the rod, patient became totally asymptomatic with normal full range of movement of the knee joint.

CONCLUSION

Though rare, migration of implants from the spine to the distant sites is always a possibility and may have severe complications too. We stress the need of long-term follow-up with clinical examination and radiographs to prevent missing such a complication.

摘要

研究设计

回顾性病例报告。

目的

本文旨在报告一种脊柱器械的罕见并发症。

背景资料概要

脊柱植入物迁移至远处部位非常罕见,截至目前,文献中仅有 2 例报告。我们首次报告了 1 例年轻男性患者在脊柱损伤后固定 4 年后,从前柱脊柱杆向膝关节迁移的病例。

方法

1 名 38 岁男性因左膝关节疼痛、肿胀和活动受限就诊。临床检查可触及可移动的硬杆,最初怀疑为金属异物。详细的病史显示,患者在 4 年前因 L1 椎体外伤性损伤后进行了前柱脊柱固定。X 线片显示金属杆位于膝关节周围,而无胸腰段脊柱前杆。通过手术探查证实了杆迁移的怀疑。

结果

取出杆后 1 周,患者完全无症状,膝关节活动范围正常。

结论

尽管罕见,但植入物从脊柱迁移至远处部位的可能性始终存在,并且可能会产生严重的并发症。我们强调需要进行长期的临床检查和 X 线随访,以防止漏诊这种并发症。

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