Cargando…
Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review
Background: Spinal fusion is a common surgery, in which vertebrae are fused to restore spinal stability and eliminate pain during movement. The use of an interbody cage facilitates spinal fusion. However, complete cage migration into the dura matter rarely occurs and can be challenging to manage. Ca...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10222961/ https://www.ncbi.nlm.nih.gov/pubmed/37241188 http://dx.doi.org/10.3390/medicina59050956 |
_version_ | 1785049825564164096 |
---|---|
author | Hsiao, Pang-Hsuan Lin, Erh-Ti Chen, Hsien-Te Lo, Yuan-Shun |
author_facet | Hsiao, Pang-Hsuan Lin, Erh-Ti Chen, Hsien-Te Lo, Yuan-Shun |
author_sort | Hsiao, Pang-Hsuan |
collection | PubMed |
description | Background: Spinal fusion is a common surgery, in which vertebrae are fused to restore spinal stability and eliminate pain during movement. The use of an interbody cage facilitates spinal fusion. However, complete cage migration into the dura matter rarely occurs and can be challenging to manage. Case Presentation: A 44-year-old man presented at our spine center with a history of incomplete paraplegia and cauda equina syndrome that had lasted for 2 years and 4 months. This condition developed after he underwent six lumbar spine surgeries to address lower back pain and right-sided sciatica. A structural allograft kidney-shaped cage was found completely within the dura at the level of the L3 vertebra. Durotomy, cage retrieval, and pedicle screw fixation from the L2 to L4 vertebrae were performed. Numbness in both lower limbs markedly decreased within several days of the operation. After four months following the progressive physical therapy, the patient could partially control both urination and defecation. Five months postoperatively, he could stand with slight assistance. Conclusions: Complete intradural cage migration is a rare and serious complication. To the best of our knowledge, this is the first reported case with such a condition in the literature. Even if treatment is delayed, surgical intervention may salvage the remaining neurologic function and may even lead to partial recovery. |
format | Online Article Text |
id | pubmed-10222961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102229612023-05-28 Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review Hsiao, Pang-Hsuan Lin, Erh-Ti Chen, Hsien-Te Lo, Yuan-Shun Medicina (Kaunas) Case Report Background: Spinal fusion is a common surgery, in which vertebrae are fused to restore spinal stability and eliminate pain during movement. The use of an interbody cage facilitates spinal fusion. However, complete cage migration into the dura matter rarely occurs and can be challenging to manage. Case Presentation: A 44-year-old man presented at our spine center with a history of incomplete paraplegia and cauda equina syndrome that had lasted for 2 years and 4 months. This condition developed after he underwent six lumbar spine surgeries to address lower back pain and right-sided sciatica. A structural allograft kidney-shaped cage was found completely within the dura at the level of the L3 vertebra. Durotomy, cage retrieval, and pedicle screw fixation from the L2 to L4 vertebrae were performed. Numbness in both lower limbs markedly decreased within several days of the operation. After four months following the progressive physical therapy, the patient could partially control both urination and defecation. Five months postoperatively, he could stand with slight assistance. Conclusions: Complete intradural cage migration is a rare and serious complication. To the best of our knowledge, this is the first reported case with such a condition in the literature. Even if treatment is delayed, surgical intervention may salvage the remaining neurologic function and may even lead to partial recovery. MDPI 2023-05-16 /pmc/articles/PMC10222961/ /pubmed/37241188 http://dx.doi.org/10.3390/medicina59050956 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Hsiao, Pang-Hsuan Lin, Erh-Ti Chen, Hsien-Te Lo, Yuan-Shun Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title | Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title_full | Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title_fullStr | Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title_full_unstemmed | Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title_short | Complete Intradural Interbody Cage Migration in Lumbar Spine Surgery: A Case Report and Literature Review |
title_sort | complete intradural interbody cage migration in lumbar spine surgery: a case report and literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10222961/ https://www.ncbi.nlm.nih.gov/pubmed/37241188 http://dx.doi.org/10.3390/medicina59050956 |
work_keys_str_mv | AT hsiaopanghsuan completeintraduralinterbodycagemigrationinlumbarspinesurgeryacasereportandliteraturereview AT linerhti completeintraduralinterbodycagemigrationinlumbarspinesurgeryacasereportandliteraturereview AT chenhsiente completeintraduralinterbodycagemigrationinlumbarspinesurgeryacasereportandliteraturereview AT loyuanshun completeintraduralinterbodycagemigrationinlumbarspinesurgeryacasereportandliteraturereview |