A Case Report of Rod Migration into Cerebellum through Foramen Magnum after Lateral Mass Fixation. Issue 1 (April 2016)

• Record Type: Journal Article
• Authors: Sharma, Ayush
• Is Part Of: Global spine journal. Volume 6:Issue 1(2016)Supplement
• Page Start: s-0036-1583151
• Page End: s-0036-1583151
• Publication Date: 2016-04
• Subjects: Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1055/s-0036-1583151
• Languages: English
• ISSNs: 2192-5682

Abstract

Introduction: There are many methods of posterior cervical fixation for various indications and each with its own early & late known complications. Among the late complications, Screw or rod pullout, screw or plate breakage, and screw loosening are common. We are reporting here, connecting rod migration into posterior cranial fossa, a rare complication after lateral mass fixation. Case Report: A 55 year old male patient was operated with lateral mass fixation after posterior cervical decompression for ossification of posterior longitudinal ligament (OPLL). Patient had symptomatic recovery without any complication postoperatively. One and half years later the patient started complaining of sudden onset giddiness followed by loss of consciousness a few hours later. Ct scan showed lateral mass screws construct with migration of left sided connecting rod into the right cerebellum through foramen magnum. Patient was operated for rod removal but he never regained consciousness and was lost on eighth postoperative day. Autopsy confirmed damage to right cerebellum due to rod migration. Conclusion: Clinician should be aware that superior rod migration is a rare but potentially disastrous complication. Regular follow up with radiological evaluation should be done to look for implant loosening, migration and non-union even in asymptomatic patients. The implant should be subsequently removed after it has served its purpose.