Sublaminar wire migration into the medulla oblongata: a case report.

Autor:	Koziarz A; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada., Aref M; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada., Vinh B; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada., Mensinkai A; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada., Almenawer SA; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada., Reddy K; 1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Journal of spine surgery (Hong Kong) [J Spine Surg] 2017 Jun; Vol. 3 (2), pp. 267-271.
DOI:	10.21037/jss.2017.05.09
Abstrakt:	Atlantoaxial procedures have been developed in an effort to ensure solid C1-C2 fusion. However, techniques that involve sublaminar wiring have the potential for neural structure injury. We present the management of a patient who previously underwent Gallie fusion 10 years ago and is presenting with a dislodged titanium wire that has migrated into the medulla oblongata. A 52-year-old female patient known with rheumatoid arthritis presented with truncal ataxia and food regurgitation 10 years after undergoing a C1-C2 Gallie fusion. A computerized tomography (CT) scan revealed that a wire from her Gallie fusion procedure migrated into the medulla oblongata. The patient underwent foramen magnum decompression with C1 bilateral laminectomy, instrumentation, and removal of a migrated wire. Six months later, a CT scan showed that all occipital screws were pulled out. In the revision surgery, new occipital screws were placed with a resultant significant improvement in patient's gait postoperatively. Wire migration as a differential diagnosis should be considered in patients presenting with neurological dysfunction who underwent surgical treatment with sublaminar wire fusion techniques. Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
Databáze:	MEDLINE
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