Delayed neurological deficit due to a medially misplaced thoracic pedicle screw during adolescent idiopathic scoliosis correction: a complication 6 years in the making.
Sudhir Suggala, Garrett A Dyess, Olivier Darbin, Richard P Menger
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引用次数: 0
Abstract
Purpose: Neurological deficits developing years after pedicle screw misplacement is a rare phenomenon. Here, we report level IV evidence of a previously asymptomatic medial thoracic pedicle screw resulting in paraparesis after a motor vehicle accident.
Methods: A 21-year-old male presented with acute onset of paraparesis following a motor vehicle collision. Six years prior this incident, the patient underwent a thoracolumbar fusion T4-L4 for AIS performed by an outside orthopedic surgeon. CT scan and CT myelogram illustrated decreased spinal canal diameter and cord compression from a medial T8 pedicle screw.
Results: Surgical removal of the misplaced pedicle screw resulted in a gradual complete recovery sustained over a period of 2 years. This case is compared to those reported in the literature review between 1981 and 2019 concerning delayed neurological deterioration related to misplaced pedicle screw.
Conclusion: This case reports a delayed neurological deficit implicating a misplaced pedicle screw. This phenomenon remains rare since 5 cases were reported in the literature over the last 4 decades. It calls into focus the need for confirmation of safe instrumentation during the intraoperative period. It also illustrates the potential difficult decision-making in regard to asymptomatic misplaced instrumentation.
期刊介绍:
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.