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Revision surgery after rod breakage in a patient with occipitocervical fusion: A case report.
Medicine (Baltimore). 2018 Apr; 97(15):e0441.M

Abstract

RATIONALE

Rod breakage after occipitocervical fusion (OCF) has never been described in a patient who has undergone surgery for basilar invagination (BI) and atlantoaxial dislocation (AAD). Here, we present an unusual but significant case of revision surgery to correct this complication.

PATIENT CONCERNS

A 32-year-old female presented with neck pain, unstable leg motion in walking, and also BI with AAD. Her first surgery was planned to correct these conditions and for fusion at the occipital junction (C3-4) using a screw-rod system. At the 31-month follow-up after her first operation, the patient complained of severe neck pain and limitation of motion, suggesting rod breakage.

DIAGNOSES

Rod breakage after occipitocervical fusion for BI and AAD.

INTERVENTIONS

The patient underwent reoperation for replacement of the broken rods, adjustment of the occipitocervical angle, maintenance of the bone graft bed, and fusion.

OUTCOMES

At follow-up, the hardware was found to be in good condition, with no significant loss of cervical lordosis. At the 37-month follow-up after her second operation, the patient was doing better and continuing to recover.

LESSONS

We concluded that nonideal choice of occipitocervical angle may play an important role in rod breakage; however, an inadequate bone graft and poor postoperative fusion may also contribute to implant failure.

Authors+Show Affiliations

Department of Spine Surgery Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29642217

Citation

Tang, Chao, et al. "Revision Surgery After Rod Breakage in a Patient With Occipitocervical Fusion: a Case Report." Medicine, vol. 97, no. 15, 2018, pp. e0441.
Tang C, Li GZ, Kang M, et al. Revision surgery after rod breakage in a patient with occipitocervical fusion: A case report. Medicine (Baltimore). 2018;97(15):e0441.
Tang, C., Li, G. Z., Kang, M., Liao, Y. H., Tang, Q., & Zhong, J. (2018). Revision surgery after rod breakage in a patient with occipitocervical fusion: A case report. Medicine, 97(15), e0441. https://doi.org/10.1097/MD.0000000000010441
Tang C, et al. Revision Surgery After Rod Breakage in a Patient With Occipitocervical Fusion: a Case Report. Medicine (Baltimore). 2018;97(15):e0441. PubMed PMID: 29642217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revision surgery after rod breakage in a patient with occipitocervical fusion: A case report. AU - Tang,Chao, AU - Li,Guang Zhou, AU - Kang,Min, AU - Liao,Ye Hui, AU - Tang,Qiang, AU - Zhong,De Jun, PY - 2018/4/12/entrez PY - 2018/4/12/pubmed PY - 2018/4/21/medline SP - e0441 EP - e0441 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 15 N2 - RATIONALE: Rod breakage after occipitocervical fusion (OCF) has never been described in a patient who has undergone surgery for basilar invagination (BI) and atlantoaxial dislocation (AAD). Here, we present an unusual but significant case of revision surgery to correct this complication. PATIENT CONCERNS: A 32-year-old female presented with neck pain, unstable leg motion in walking, and also BI with AAD. Her first surgery was planned to correct these conditions and for fusion at the occipital junction (C3-4) using a screw-rod system. At the 31-month follow-up after her first operation, the patient complained of severe neck pain and limitation of motion, suggesting rod breakage. DIAGNOSES: Rod breakage after occipitocervical fusion for BI and AAD. INTERVENTIONS: The patient underwent reoperation for replacement of the broken rods, adjustment of the occipitocervical angle, maintenance of the bone graft bed, and fusion. OUTCOMES: At follow-up, the hardware was found to be in good condition, with no significant loss of cervical lordosis. At the 37-month follow-up after her second operation, the patient was doing better and continuing to recover. LESSONS: We concluded that nonideal choice of occipitocervical angle may play an important role in rod breakage; however, an inadequate bone graft and poor postoperative fusion may also contribute to implant failure. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/29642217/Revision_surgery_after_rod_breakage_in_a_patient_with_occipitocervical_fusion:_A_case_report_ L2 - https://doi.org/10.1097/MD.0000000000010441 DB - PRIME DP - Unbound Medicine ER -