AbstractRationale:Malposition of cervical pedicle screw (CPS) has a risk of vertebral artery (VA) injury which sometimes may cause unexpected and catastrophic outcome. A rare case of delayed onset of cerebral infarction caused by malposition of CPS was reported.Patient concerns:A 23-year-old man who underwent a posterior cervical reduction and fusion of C4–5 using CPS fixation and allograft for cervical spine injury is presented. The patient suffered progressively weakness and numbness for both of upper and lower extremities 1 day after the operation. Computed tomography scans revealed bilateral occupation of the pedicle screws in the foramen of C4 and C5 and the magnetic resonance imaging (MRI) displayed several areas of infarction in the brainstem and cerebellum.Diagnoses:Plain radiographs of the cervical spine revealed the C4 vertebral body and MRI displayed a disruption of the anterior longitudinal ligament on the level of C4–5 and severe injury to the soft tissues of the cervical spine at admission. Brainstem and cerebellum infarction was diagnosed at postoperative.Intervention:A revision surgery was decided to remove all of the pedicle screws and place lateral mass screws instead.Outcomes:The patient felt better on his all of 4 extremities following revision surgery. Fortunately, he was neurologically close to normal at a 3-month follow-up.Lessons:Delayed onset of cerebral infarction is rarely reported complication caused by malposition of CPS. When a CPS perforates the transverse foramen and causes symptom of cerebral infarction, a revision surgery in time is strongly recommended to prevent further sequelae.
Medicine – Wolters Kluwer Health
Published: Feb 1, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
All the latest content is available, no embargo periods.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud