Cai Siyi, Kong Xiangyi, Yan Chengrui, Wang Yipeng, Wan Xueshuai, Zhang Jialu, Qiu Guixing, Yu Keyi
Department of Orthopaedic Surgery Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, MA.
Medicine (Baltimore). 2017 Mar;96(12):e6425. doi: 10.1097/MD.0000000000006425.
The objective of this article is to report an unusual case of a spinal rod that protruded into the spinal canal after lumbar spine surgery.Only 4 cases of spinal rod migration with protrusion into the spinal canal have been reported. This is the first report of a case involving the use of posterior low lumbar segmental instrumentation with a screw-rod system. The left side of the rod gradually migrated and finally protruded into the canal and compressed the cord.A 60-year-old woman presented with pain and numbness of the posterior aspect of the left leg after a long-distance walk. Intermittent claudication became worse, and she developed pain and numbness in the perineal region. An x-ray showed that the left side of a spinal rod among the segmental spinal instruments that had been placed 10 years previously had protruded into the spinal canal.We removed the rod and decompressed the canal at the level of L5-S1. The patient became totally asymptomatic.Rods used as spinal instrumentation have the possibility of protruding into the spinal canal and endangering the nervous system. Long-term follow-up with radiological examinations should be conducted upon completion of spinal operations conducting using instrumentation.
本文的目的是报告一例腰椎手术后脊柱棒突入椎管的罕见病例。仅有4例脊柱棒移位并突入椎管的病例被报道。这是首例涉及使用后路低位腰椎节段性螺钉-棒系统内固定的病例报告。棒的左侧逐渐移位,最终突入椎管并压迫脊髓。一名60岁女性在长途行走后出现左腿后侧疼痛和麻木。间歇性跛行加重,并且她在会阴区出现疼痛和麻木。X线显示,10年前放置的节段性脊柱器械中的一根脊柱棒的左侧突入了椎管。我们取出了棒并在L5-S1水平对椎管进行了减压。患者完全无症状。用作脊柱内固定的棒有可能突入椎管并危及神经系统。在完成使用器械的脊柱手术后,应进行影像学检查的长期随访。