• David T Wong, Michael G Fehlings, and Eric M Massicotte.
• Division of Neurosurgery, Department of Anesthesiology, University of Toronto, Ontario, Canada. david.wong@uhn.on.ca
• Spine. 2005 Nov 15; 30 (22): E683-6.

Study DesignCase report of late postoperative complication.Summary Of Background DataThere have been a number of reports of migration and extrusion of cervical fusion instrumentation. The majority of such cases have a benign outcome. To our knowledge, cervical instrumentation extrusion resulting in prevertebral abscess and acute airway obstruction has not been reported.MethodsA 56-year-old man who had undergone a prior C3-C6 anterior cervical decompression and fusion presented to a hospital with dysphagia and acute airway obstruction requiring an emergency tracheostomy. His neck radiograph showed that a C6 screw was missing compared to prior films. Magnetic resonance imaging showed a large prevertebral abscess anterior to C2-C7 causing complete upper airway obstruction.ResultsHe underwent surgical drainage of the abscess and had a good neurologic recovery.ConclusionsWe report a case of acute upper airway obstruction from prevertebral abscess, likely secondary to a loosened anterior cervical screw penetrating the prevertebral soft tissue. In contrast to case reports in the literature involving instrumentation extrusion with a usually benign outcome, our case presented with a life-threatening condition.

20 keywords...

hide…