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Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring

Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of d...

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Detalles Bibliográficos
Autores principales: Tullos, Hurtis J, Briggs, Robert G, Conner, Andrew K, Williams, Allison E, Maxwell, John B, Martin, Michael D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898836/
https://www.ncbi.nlm.nih.gov/pubmed/29662730
http://dx.doi.org/10.7759/cureus.2191
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author Tullos, Hurtis J
Briggs, Robert G
Conner, Andrew K
Williams, Allison E
Maxwell, John B
Martin, Michael D
author_facet Tullos, Hurtis J
Briggs, Robert G
Conner, Andrew K
Williams, Allison E
Maxwell, John B
Martin, Michael D
author_sort Tullos, Hurtis J
collection PubMed
description Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord. In the present case, the construct was removed and the patient underwent a durotomy repair and a posterior fusion of cervical levels 1 and 2 via screw placement under image guidance with a subsequent functional improvement back to baseline. We report this case and review the literature on the complications associated with cervical wire fusion and the methods of minimizing these risks.
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spelling pubmed-58988362018-04-16 Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring Tullos, Hurtis J Briggs, Robert G Conner, Andrew K Williams, Allison E Maxwell, John B Martin, Michael D Cureus Neurosurgery Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord. In the present case, the construct was removed and the patient underwent a durotomy repair and a posterior fusion of cervical levels 1 and 2 via screw placement under image guidance with a subsequent functional improvement back to baseline. We report this case and review the literature on the complications associated with cervical wire fusion and the methods of minimizing these risks. Cureus 2018-02-14 /pmc/articles/PMC5898836/ /pubmed/29662730 http://dx.doi.org/10.7759/cureus.2191 Text en Copyright © 2018, Tullos et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Tullos, Hurtis J
Briggs, Robert G
Conner, Andrew K
Williams, Allison E
Maxwell, John B
Martin, Michael D
Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title_full Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title_fullStr Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title_full_unstemmed Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title_short Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring
title_sort myelopathy improvement following removal of cervical sublaminar wiring
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898836/
https://www.ncbi.nlm.nih.gov/pubmed/29662730
http://dx.doi.org/10.7759/cureus.2191
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