Leiva-Juarez Miguel M, Greenberg Yitzchok, La Punzina Charles
Department of Surgery, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States.
Department of Surgery, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States; Department of Thoracic Surgery, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States.
Int J Surg Case Rep. 2018;46:6-8. doi: 10.1016/j.ijscr.2018.03.037. Epub 2018 Mar 29.
Spinal fixation is a common surgical procedure. Frequently, fixation for spinal stabilization requires use of instrumentation such as pedicle screws and fixation plates. Aerodigestive and vascular perforations from such procedures are infrequent albeit known complications from these procedures.
This case details an uncommon situation in which a patient with anterior cervical spine fixation in the distant past was found to have a migratory pedicle screw. The patient had symptoms of neck pain and dysphagia. Radiographic studies were helpful in demonstrating the problem. While undergoing a physical examination, the patient was witnessed to expectorate the screw. Further work up with panendoscopy was undertaken and the patient managed conservatively.
The upper aerodigestive system rarely experiences perforation from spinal stabilization hardware. When it occurs, management should include a dedicated investigation of the involved portions of the digestive system to avoid further complication.
This case presents an rare occurrence of aerodigestive perforation of a spinal pedicle screw which was self-removed.
脊柱固定是一种常见的外科手术。通常，用于脊柱稳定的固定需要使用诸如椎弓根螺钉和固定板等器械。尽管这些手术已知会出现并发症，但由此导致的气道消化道和血管穿孔并不常见。
本病例详细描述了一种罕见情况，一名多年前接受过颈椎前路固定的患者被发现有一枚游走的椎弓根螺钉。患者有颈部疼痛和吞咽困难的症状。影像学检查有助于发现问题。在体格检查过程中，目睹患者咳出了螺钉。随后进行了全面的内镜检查，并对患者进行了保守治疗。
上气道消化道系统很少因脊柱稳定器械而发生穿孔。一旦发生，处理应包括对消化系统受累部分进行专门检查，以避免进一步并发症。
本病例呈现了一种罕见的情况，即一枚椎弓根螺钉导致气道消化道穿孔，而该螺钉自行排出。
