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J Craniovertebr Junction Spine. 2012 Jan;3(1):19-22. doi: 10.4103/0974-8237.110121.

Delayed anterior cervical plate dislodgement with pharyngeal wall perforation and oral extrusion of cervical plate screw after 8 years: A very rare complication.

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1
Post Graduate Institute of Neurological Surgery, Dr. A. Lakshmipathi Neurosurgical Centre, VHS Hospital, Chennai, Tamil Nadu, India.

Abstract

We report a patient with congenital anomaly of cervical spine, who presented with clinical features suggestive of cervical compressive spondylotic myelopathy. He underwent C3 median corpectomy, graft placement, and stabilization from C2 to C4 vertebral bodies. Postoperative period was uneventful and he improved in his symptoms. Eight years later, he presented with a difficulty in swallowing and occasional regurgitation of feeds of 2 months duration and oral extrusion of screw while having food. On oral examination, there was a defect in the posterior pharyngeal wall through which the upper end of plate with intact self-locking screw and socket of missed fixation screw was seen. This was confirmed on X-ray cervical spine. He underwent removal of the plate system and was fed through nasogastric tube and managed with appropriate antibiotics. This case is presented to report a very rare complication of anterior cervical plate fixation in the form of very late-onset dislodgement, migration of anterior cervical plate, and oral extrusion of screw through perforated posterior pharyngeal wall.

KEYWORDS:

Cervical spine complication; delayed pharyngeal wall perforation; missing screw; oral extrusion of fixation screw; plate migration and dislodgement; screw pullout

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