Abstract
Study Design
Case report.
Objectives
To describe a patient who experienced rod fracture with subsequent caudal migration into the gluteal region after minimally invasive posterior spinal fusion for adult idiopathic scoliosis.
Summary of Background Data
Rod fracture occurs in approximately 6.8% of patients who undergo multilevel instrumented arthrodesis for spinal deformity. Rod fracture can result in substantial morbidity including pain, loss of deformity correction, and pseudoarthrosis.
Methods
A retrospective chart review was used to describe the clinical course and radiographic findings after rod fracture. Previous methods of implant failure were reviewed in the literature.
Results
The patient underwent a minimally incisional posterior spinal fusion and experienced bilateral rod fracture caused by pseudarthrosis within 2 years. One of these fractured rods disengaged from the pedicle screw sleeves and migrated caudally to the gluteal region and proximal posterior thigh. The fractured rod was surgically removed from the gluteal region without complication.
Conclusions
The patient presented with a highly unusual method of implant failure after posterior spinal fusion. Although uncommon, spine surgeons should be aware of the possibility of caudal migration after rod fracture.
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References
Suk SI, Lee CK, Kim WJ, et al. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 1995;20:1399–405.
Lykissas MG, Crawford AH, Jain VV. Complications of surgical treatment of pediatric spinal deformities. Orthop Clin North Am 2013;44:357–70. ix.
Smith JS, Shaffrey CI, Ames CP, et al. Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity. Neurosurgery 2012;71:862–7.
Scheer JK, Tang JA, Smith JS, et al. Reoperation rates and impact on outcome in a large, prospective, multicenter, adult spinal deformity database. J Neurosurg Spine 2013;19:464–70.
Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 1962;44:591–610.
Yoshihara H. Rods in spinal surgery: a review of the literature. Spine J 2013;13:1350–8.
Anand N, Baron EM, Khandehroo B, Kahwaty S. Long-term 2- to 5-year clinical and functional outcomes of minimally invasive surgery for adult scoliosis. Spine (Phila Pa 1976) 2013;38:1566–75.
Berjano P, Bassani R, Casero G, et al. Failures and revisions in surgery for sagittal imbalance: analysis of factors influencing failure. Eur Spine J 2013;22(Suppl 6):S853–8.
Stauffer RN, Coventry MB. Anterior interbody lumbar spine fusion: analysis of Mayo Clinic series. J Bone Joint Surg Am 1972;54:756–68.
Swank S, Lonstein JE, Moe JH, et al. Surgical treatment of adult scoliosis: a review of two hundred and twenty-two cases. J Bone Joint Surg Am 1981;63:268–87.
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Author disclosures: SKD (none); AHC (none) FSA (none).
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Dailey, S.K., Crawford, A.H. & Asghar, F.S. Implant Failure Following Posterior Spinal Fusion—Caudal Migration of a Fractured Rod: Case Report. Spine Deform 3, 380–385 (2015). https://doi.org/10.1016/j.jspd.2015.02.001
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DOI: https://doi.org/10.1016/j.jspd.2015.02.001