Cerebral infarction resulting from malposition of cervical pedicle screw: A case report.
Drugs (Baltimore). 2018 Feb;97(7):e9937
Authors: Zhang J, Xu R, Li Z, Zha W
RATIONALE: Malposition of cervical pedicle screw (CPS) has a threat of vertebral artery (VA) damage which typically could trigger sudden and catastrophic end result. A uncommon case of delayed onset of cerebral infarction brought on by malposition of CPS was reported.
PATIENT CONCERNS: A 23-year-old man who underwent a posterior cervical discount and fusion of C4-5 utilizing CPS fixation and allograft for cervical backbone damage is introduced. The affected person suffered progressively weak spot and numbness for each of higher and decrease extremities 1 day after the operation. Computed tomography scans revealed bilateral occupation of the pedicle screws within the foramen of C4 and C5 and the magnetic resonance imaging (MRI) displayed a number of areas of infarction within the brainstem and cerebellum.
DIAGNOSES: Plain radiographs of the cervical backbone revealed the C4 vertebral physique and MRI displayed a disruption of the anterior longitudinal ligament on the extent of C4-5 and extreme damage to the mushy tissues of the cervical backbone at admission. Brainstem and cerebellum infarction was recognized at postoperative.
INTERVENTION: A revision surgical procedure was determined to take away the entire pedicle screws and place lateral mass screws as a substitute.
OUTCOMES: The affected person felt higher on his all of four extremities following revision surgical procedure. Happily, he was neurologically near regular at a Three-month follow-up.
LESSONS: Delayed onset of cerebral infarction is never reported complication brought on by malposition of CPS. When a CPS perforates the transverse foramen and causes symptom of cerebral infarction, a revision surgical procedure in time is strongly really helpful to stop additional sequelae.
PMID: 29443779 [PubMed – indexed for MEDLINE]