Rod migration to the occiput after C3-7 instrumentation: A rare case report and literature review.

Introduction and importance: Cervical canal stenosis often requires posterior laminectomy with lateral mass (LM) screw/rod fixation for sagittal stability. Although rare, rod migration can pose serious risks, such as penetration into cranial structures, emphasizing the need for vigilant postoperative monitoring and prompt intervention.

Case presentation: A 65-year-old male with no significant prior medical history underwent C3-7 laminectomy with LM screw/rod fixation for cervical canal stenosis. Two months postoperatively, the patient experienced persistent neck pain. Imaging revealed right-sided rod migration into the occipital bone, confirmed by CT scan. Urgent revision surgery was performed to remove the migrated rod, resulting in a successful recovery without further complications during follow-up evaluations.

Clinical discussion: Rod migration is a rare but serious complication of LM screw/rod fixation, influenced by technical factors such as screw placement, angulation, and rod length. Accurate preoperative planning, meticulous surgical technique, and detailed postoperative surveillance are crucial in preventing such occurrences. This case highlights the significance of recognizing potential hardware complications early, facilitated by imaging modalities like CT, to avoid severe neurological outcomes.

Conclusion: This case underscores the necessity of thorough preoperative assessment, precise surgical execution, and rigorous postoperative monitoring in managing cervical spine stabilization surgeries. Improved diagnostic imaging and prompt surgical intervention are key to mitigating risks associated with rod migration, ultimately enhancing patient outcomes.