BACKGROUND: Complications caused by osteosynthetic material after cervical spine surgery are rare. PATIENT AND METHOD: The case of a 36-year-old patient is reported, who suffered the extrusion of a screw and migration through the hypopharynx after ventral spondylodesis of a cervical spine fracture. RESULT: Dysphagia occurred shortly after spinal surgery. The lack of one osteosynthesis screw in the spine was detected by X-ray and the material was located in the rectum. The screw had passed through the intestinal tract and was excreted spontaneously. An ENT medical control was carried out because of persisting dysphagia. Endoscopy revealed a cherry-sized granuloma of the posterior hypopharynx wall which was removed surgically. The healing process of the mucosa continued without further complications. CONCLUSION: X-ray control and endoscopy are required immediately when dysphagia occurs after osteosynthesis of the cervical spine due to possible complications caused by the implanted material. Further therapeutic measures depend on the case-specific constellation.
BACKGROUND: Complications caused by osteosynthetic material after cervical spine surgery are rare. PATIENT AND METHOD: The case of a 36-year-old patient is reported, who suffered the extrusion of a screw and migration through the hypopharynx after ventral spondylodesis of a cervical spine fracture. RESULT: Dysphagia occurred shortly after spinal surgery. The lack of one osteosynthesis screw in the spine was detected by X-ray and the material was located in the rectum. The screw had passed through the intestinal tract and was excreted spontaneously. An ENT medical control was carried out because of persisting dysphagia. Endoscopy revealed a cherry-sized granuloma of the posterior hypopharynx wall which was removed surgically. The healing process of the mucosa continued without further complications. CONCLUSION: X-ray control and endoscopy are required immediately when dysphagia occurs after osteosynthesis of the cervical spine due to possible complications caused by the implanted material. Further therapeutic measures depend on the case-specific constellation.
Authors: Wolfgang Pichler; Alfred Maier; Thomas Rappl; Hans Gunther Clement; Wolfgang Grechenig Journal: Spine (Phila Pa 1976) Date: 2006-04-20 Impact factor: 3.468