Kapu Ravindranath, Singh Manish, Pande Anil, Vasudevan Matabushi Chakravarthy, Ramamurthi Ravi
Post Graduate Institute of Neurological Surgery, Dr. A. Lakshmipathi Neurosurgical Centre, VHS Hospital, Chennai, Tamil Nadu, India.
J Craniovertebr Junction Spine. 2012 Jan;3(1):19-22. doi: 10.4103/0974-8237.110121.
We report a patient with congenital anomaly of cervical spine, who presented with clinical features suggestive of cervical compressive spondylotic myelopathy. He underwent C3 median corpectomy, graft placement, and stabilization from C2 to C4 vertebral bodies. Postoperative period was uneventful and he improved in his symptoms. Eight years later, he presented with a difficulty in swallowing and occasional regurgitation of feeds of 2 months duration and oral extrusion of screw while having food. On oral examination, there was a defect in the posterior pharyngeal wall through which the upper end of plate with intact self-locking screw and socket of missed fixation screw was seen. This was confirmed on X-ray cervical spine. He underwent removal of the plate system and was fed through nasogastric tube and managed with appropriate antibiotics. This case is presented to report a very rare complication of anterior cervical plate fixation in the form of very late-onset dislodgement, migration of anterior cervical plate, and oral extrusion of screw through perforated posterior pharyngeal wall.
我们报告了一名患有颈椎先天性异常的患者，其临床表现提示为颈椎压迫性脊髓病。他接受了C3椎体次全切除、植骨以及C2至C4椎体的固定手术。术后恢复顺利，症状有所改善。八年后，他出现吞咽困难，持续两个月偶尔有食物反流，进食时螺钉从口腔脱出。口腔检查发现咽后壁有缺损，可见带有完整自锁螺钉的钢板上端以及漏固定螺钉的螺帽。颈椎X线检查证实了这一情况。他接受了钢板系统取出术，通过鼻胃管进食，并使用了适当的抗生素进行治疗。本文报告了一例非常罕见的颈椎前路钢板固定并发症，表现为极晚期钢板移位、颈椎前路钢板迁移以及螺钉通过穿孔的咽后壁从口腔脱出。
