Postoperative intracranial migration of a C2 odontoid screw: A case report and literature review
| Autor: | Ankush Chandra, Blake Walker, Emre Yilmaz, Robert M. Johnson, Seong-Jin Moon, Marc Moisi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Case Report C2 odontoid screw Screw fixation 03 medical and health sciences 0302 clinical medicine Lag screw medicine Anterior odontoid screw fixation Postoperative intracranial migration 030222 orthopedics medicine.diagnostic_test business.industry Instrumented fusion Magnetic resonance imaging musculoskeletal system equipment and supplies Cervicomedullary Junction Surgery surgical procedures operative Cervical arthrodesis Angiography Neurology (clinical) Complication business 030217 neurology & neurosurgery |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 |
| Popis: | Background: Intracranial migration of odontoid screws is a rare but serious complication of anterior odontoid screw fixation not often reported in literature by neurosurgeons. Here, we describe the second case in literature of intracranial migration of an odontoid screw. Case Description: A 64-year-old neurologically intact patient with a type II odontoid fracture secondary to trauma underwent anterior odontoid screw fixation without any intraoperative complications. He tolerated the procedure well, and postoperative imaging demonstrated near anatomic correction of the fracture with satisfactory placement of the lag screw. Unfortunately, the patient was subsequently lost to follow up and he presented 7 months later for a routine outpatient computed tomography (CT) of the cervical spine, which demonstrated upward migration of the screw into the intracranial cavity abutting the medulla, with CT angiography of the neck also confirming the screw lying between the two vertebral arteries. Magnetic resonance imaging of the cervical spine also demonstrated the odontoid screw lying within close proximity to the ventral cervicomedullary junction, marginating the left vertebral artery. Subsequently, the patient was managed with removal of the odontoid screw and posterior cervical arthrodesis and instrumented fusion. Conclusion: Our case demonstrates the rare but serious complication of intracranial odontoid screw migration, which we bring to the attention of the neurosurgical community. The recognition of risk factors for this complication and optimized management of this rare occurrence is important for surgeons to recognize. |
| Databáze: | OpenAIRE |
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