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Missing anterior cervical plate and screws: a case report
S Fujibayashi1, J Shikata, N Kamiya
1Department of Orthopaedic Surgery, Kyoto City Hospital, Higashitakada-cho, Mibu, Nakagyo-ku, Kyoto, Japan. shfuji@kuhp.kyoto-u.ac.jp
Spine
|September 6, 2000
Summary
An anterior cervical plate and screws disappeared completely after dislodgment, likely passing through the gastrointestinal tract without significant morbidity. This rare complication highlights potential, albeit unusual, outcomes of cervical implants.
Area of Science:
- Spinal Surgery
- Neurosurgery
- Gastroenterology
Background:
- Anterior cervical plating is a common procedure for stabilizing cervical spine injuries.
- Complete disappearance of cervical implants is an exceptionally rare complication.
- No prior literature documented such an event.
Observation:
- A case of a missing anterior cervical plate and screws following a cervical implant procedure.
- The dislodged implant was associated with methicillin-resistant Staphylococcus aureus (MRSA) infection.
- The implants were presumed to have passed through the gastrointestinal tract over three months.
Findings:
- Complete disappearance of the anterior cervical plate and screws.
- No residual implants detected via whole-body fluoroscopy.
- Absence of esophageal fistula confirmed by barium swallow study.
- The patient experienced minimal morbidity despite the implant's migration.
Implications:
- This case presents a unique complication of cervical spine surgery, involving implant migration and passage through the GI tract.
- The role of MRSA infection in this event remains speculative but warrants consideration.
- Further investigation into the biomechanics and potential risk factors for such implant migration is needed.