Pneumocephalus and Pneumorrhachis Following Titanium Rib Implant: A Case Report and Literature Review.

Abstract

Introduction: Pneumocephalus and pneumorrhachis are rare postoperative complications, commonly occurring within a few days to months after spinal surgery. They are very rarely reported after thoracic surgeries. This case highlights a unique presentation in the emergency department involving headache and vomiting caused by late complications following thoracic surgery with a titanium rib implant.

Case presentation: A 64-year-old male presented to the emergency department with headache and vomiting without fever since prior 1 week. He had a history of left lower lobectomy and thoracic wall reconstruction with a titanium rib implant 40 days earlier due to epidermoid lung cancer. Computed tomography imaging of head and thorax revealed bilateral pneumocephalus and extensive pneumorrhachis. After removal of the rib implant and dural repair, the patient fully recovered.

Conclusion: This case underscores the importance of early imaging and diagnosis in patients presenting with neurological symptoms following thoracic surgery and emphasizes the need for enhanced monitoring protocols for patients with titanium implants.