Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White Building 502, Boston, Massachusetts 02114, USA.
J Clin Neurosci. 2012 Feb;19(2):310-3. doi: 10.1016/j.jocn.2011.05.018. Epub 2011 Nov 17.
Spine injury resulting from migration of previously implanted appendicular skeleton fixation hardware is rare. We present a 41-year-old man who had Steinmann fixation pins placed for a left clavicular fracture 2 years prior. He presented with a burning sensation over his biceps bilaterally and numbness over the left anterior chest and abdomen following a significant blunt traumatic injury. A CT scan revealed migration of a fractured Steinmann pin entering the left C8 neural foramen, traversing anterior to the spinal cord. The patient underwent a left C7 hemilaminectomy, foraminal decompression, and first rib resection to identify the extraforaminal portion of the pin and remove it under direct vision. He recovered uneventfully. We conclude that a principle of safe surgical removal includes adequate exposure to allow for direct visualization of the pin and neural structures. We review the evaluation and management strategies of this unusual condition.
先前植入的四肢骨骼固定硬件迁移导致的脊柱损伤很少见。我们介绍了一位 41 岁的男性，他在 2 年前因左锁骨骨折接受了斯氏针固定。他在遭受严重钝器伤后出现双侧肱二头肌烧灼感和左前胸腹部麻木。CT 扫描显示一根骨折的斯氏针迁移进入左侧 C8 神经孔，穿过脊髓前方。患者接受了左 C7 半椎板切除术、神经孔减压和第一肋骨切除术，以确定针的椎间部分并在直视下取出。他恢复顺利。我们得出结论，安全手术切除的原则包括充分暴露，以允许直接观察针和神经结构。我们回顾了这种不常见情况的评估和管理策略。
