Barrios Rodolfo, Serna Adriana, Carvajal Carlos, Villate Juan, Cabrera Vargas Luis Felipe, Vinck Eric, Sanchez Ussa Sebastian, Pedraza Ciro Mauricio
Department of Thoracic Surgery, Universidad El Bosque, Bogotá, Colombia.
Department of General Surgery, Universidad El Bosque, Bogotá, Colombia.
Respir Med Case Rep. 2018 May 18;24:153-154. doi: 10.1016/j.rmcr.2018.05.018. eCollection 2018.
Thoracic spinal surgery has many complications ranging from surgical site infection, chronic pain, periarticular arthrosis, displacement of spinal screws and hardware migration to a lesser degree. Reports of spinal implants penetrating the aorta have been described in the literature, however to our knowledge, lower airway obstruction due to spinal hardware migration has not been reported. Here we describe a case of a patient presenting with a right main stem bronchial obstruction and pneumonia secondary to the migration of the surgical spinal hardware into the lower airway 18 years after his initial intervention. We describe our surgical approach, management and outcomes using bronchoscopy and open thoracotomy. Bronchial obstruction is not a common complication of thoracic spinal surgery, however in remote cases patients may present with rare consequences, it is therefore important to pay close attention to patients' clinical and surgical history since surgical complications may appear years after.
胸段脊柱手术有许多并发症，范围从手术部位感染、慢性疼痛、关节周围关节炎、脊柱螺钉移位和内固定装置移位（程度较轻）。文献中已有脊柱植入物穿透主动脉的报道，然而据我们所知，尚未有因脊柱内固定装置移位导致下气道梗阻的报道。在此，我们描述一例患者，在初次干预18年后，因手术脊柱内固定装置移位至下气道，出现右主支气管梗阻和肺炎。我们描述了使用支气管镜检查和开胸手术的手术方法、处理措施及结果。支气管梗阻并非胸段脊柱手术的常见并发症，然而在远期病例中，患者可能出现罕见的后果，因此密切关注患者的临床和手术史很重要，因为手术并发症可能在数年之后才出现。
