Minić Ljubodrag, Lepić Milan, Novaković Nenad, Mandić-Rajčević Stefan
Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia; and.
Department of Health Sciences of the University of Milan, International Centre for Rural Health of the University Hospital San Paolo, and Laboratory for Analytical Toxicology and Metabolomics, Milano, Italy.
J Neurosurg Spine. 2016 Feb;24(2):291-294. doi: 10.3171/2015.5.SPINE1596. Epub 2015 Oct 9.
The migration of Kirschner wires (K-wires) is a rare but significant complication of osteosynthesis interventions, and numerous cases of wire migrations have been reported in the literature. Nevertheless, migration into the spinal canal is very rare, with only 10 cases reported thus far. The authors present a case of K-wire migration into the spinal canal, together with a review of the relevant literature. A 30-year-old male who had suffered a right clavicle fracture in a motorcycle accident was treated with 2 K-wires. Four months after the initial fixation, while he was lifting his child, he experienced short-term pain in his back, numbness in all 4 extremities, followed by a spontaneous decrease in numbness affecting only the ulnar nerve dermatomes bilaterally, and a persistent headache. No urinary incontinence was present. Simple radiography studies of the cervical spine revealed a wire in the spinal canal, penetrating the T-2 foramen and reaching the contralateral foramen of the same vertebra. Computerized tomography showed the wire positioned in front of the spinal cord. Surgery for wire extraction was performed with the patient under general anesthesia, and he experienced relief of the symptoms immediately after surgery. This case is unique because the wire caused no damage to the spinal cord but did cause compression-related symptomatology and headache, which have not been reported in osteosynthesis wire migration to the thoracic region.
克氏针移位是骨固定手术中一种罕见但严重的并发症，文献中已报道了许多克氏针移位的病例。然而，移位至椎管内的情况非常罕见，迄今为止仅报道了10例。本文作者报告了1例克氏针移位至椎管内的病例，并对相关文献进行了综述。一名30岁男性在摩托车事故中右锁骨骨折，接受了两根克氏针治疗。初次固定4个月后，他在抱起孩子时，背部出现短暂疼痛，四肢麻木，随后麻木感自发减轻，仅双侧尺神经皮节仍有麻木，且持续头痛。无尿失禁症状。颈椎X线平片显示椎管内有一根针，穿过T-2椎间孔并到达同一椎体的对侧椎间孔。计算机断层扫描显示针位于脊髓前方。在全身麻醉下为患者进行了取针手术，术后症状立即缓解。该病例的独特之处在于，针未对脊髓造成损伤，但确实引起了与压迫相关的症状和头痛，这在骨固定针移位至胸段的病例中尚未见报道。
