Case: Unusual Migration of Osteosynthetic Material

Wandering rod: form lumbar spine into left pleural cavity with nerve irritated symptoms

Spinal instrumented rod migrating from the surgical site to another remote site in the body is rare. Some cases result in organ or blood vessel injury. Most reported cases were asymptomatic until the finally injuries were generated. We report a unique case of spinal implant failure in which the rod moved from lumbar spine into chest 13 years post lumbar instrumentation. The migrated rod caused no damage to the organs in the pleural cavity but did cause an atypical pleural irritation syndrome which seemed to correlate with the mechanical irritation caused by the rod. These atypical symptoms of rod migration have not been reported previously.

Migration of rod into retroperitoneal region: a case report and review of the literature

Spinal stabilization with fusion is the widely used method for traumatic or pathologic fracture of spine, spinal stenosis, and spondylolisthesis. Complications may emerge during or after the operations. Infection, hematoma and neurological deficits are early noticed findings. Screw and/or rod fractures present in long-term after surgery. Rod migration in out of the spinal column is a rare entity. A 67-year-old woman was visited our clinic for right leg pain. She had a previous spinal instrumentation surgery for spondylolisthesis in another center 6 years before. After radiological work-up, a distally migrated rod piece was observed in the retroperitoneal portion. The patient was operated for degenerative change; old instruments were replaced and extended to the L2 level with posterior spinal fusion. After the operation, her right leg pain improved. The asymptomatic migrated rod piece has regularly been followed clinically and radiologically, since then. Although it has rarely been reported, migration of the instrumentation material should be kept in mind. Spinal fixation without fusion makes the mechanical system vulnerable to motion effects of spine, especially in a degenerative and osteoporotic background. Long-term, even life-long follow-up is necessary for late term complications.

Video-Assisted Thoracoscopic Surgery for Pneumothorax Induced by Migration of a K-Wire to the Chest

A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.