Cervicothoracic postarachnoiditic hydrosyringomyelia secondary to pedicular hook dislocation: case report
Pasqualino Ciappetta1, Pietro Ivo D'Urso, Carlo Delvecchio
1Department of Neurosciences, University of Bari Medical School, Bari, Italy. durso.pietroivo@libero.it
Surgical Neurology
|January 22, 2008
Summary
A rare complication of scoliosis surgery, pedicular hook dislocation, led to hydrosyringomyelia. Early detection and proper spinal device placement are crucial for preventing such serious neurological issues.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Pediatric Orthopedics
Background:
- Pedicular hook dislocation is a rare complication following spinal instrumentation for scoliosis.
- This case presents the first reported instance of hydrosyringomyelia secondary to intracanalar hook displacement.
Observation:
- A 15-year-old female developed neck pain, lower extremity numbness, and urinary disturbance post-scoliosis surgery.
- MRI revealed an intramedullary cystic cavity (C5-T7), and CT confirmed intracanalar hook displacement.
- The patient exhibited lower extremity weakness and sensory deficits below T4.
Findings:
- Surgical intervention included hook removal, laminectomy, and dural opening to address arachnoid scarring and spinal cord adhesion.
- A syringosubarachnoid catheter was placed to restore cerebrospinal fluid (CSF) flow.
- The patient's condition highlights the potential for late-onset complications from spinal instrumentation.
Implications:
- This case underscores the critical importance of precise spinal device placement during scoliosis surgery.
- Regular and thorough follow-up is essential for early detection of potential complications like hook displacement.
- Understanding the pathogenetic pathway of post-arachnoiditic syringomyelia is vital for managing such rare neurological sequelae.
