Delayed intracranial migration of cervical sublaminar and interspinous wires and subsequent cerebellar abscess. Case report

• Published in: Journal of neurosurgery Vol. 97; no. 1 Suppl; p. 113
• Main Authors: Stevenson, Kevin L, Wetzel, Matthew, Pollack, Ian F
• Format: Journal Article
• Language: English
• Published: United States 01.07.2002
• Subjects: Adolescent; Anti-Bacterial Agents - therapeutic use; Bone Wires - adverse effects; Brain Abscess - diagnosis; Brain Abscess - drug therapy; Brain Abscess - etiology; Brain Abscess - surgery; Cerebellar Diseases - diagnosis; Cerebellar Diseases - drug therapy; Cerebellar Diseases - etiology; Cerebellar Diseases - surgery; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Foreign-Body Migration - complications; Foreign-Body Migration - diagnosis; Foreign-Body Migration - etiology; Foreign-Body Migration - surgery; Humans; Magnetic Resonance Imaging; Male; Nafcillin - therapeutic use; Penicillins - therapeutic use; Reoperation; Rifampin - therapeutic use; Spinal Fusion - adverse effects; Spinal Fusion - instrumentation; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - etiology; Staphylococcal Infections - surgery; Tomography, X-Ray Computed
• ISSN: 0022-3085
• DOI: 10.3171/spi.2002.97.1.0113

Delayed complications associated with sublaminar and interspinous wiring in the pediatric cervical spine are rare. The authors present a case of delayed complication in which a cervical fusion wire migrated into the cerebellum, causing subsequent cerebellar abscess 2 years after posterior cervical arthrodesis. A craniotomy was required to remove the wire and drain the abscess. Despite their history of safety and successful fusion, procedures involving sublaminar and interspinous wiring carry a risk of neurological injury secondary to wire migration. A thorough neuroimaging evaluation is required in patients who have undergone fusion and who have neurological complaints to detect late instrumentation-related sequelae.