Tulip-Screw Head Disjunction from Posterior C2 Fracture Fixation Instrumentation.
Journal
Case reports in orthopedics
ISSN: 2090-6749
Titre abrégé: Case Rep Orthop
Pays: United States
ID NLM: 101591806
Informations de publication
Date de publication:
2020
2020
Historique:
received:
28
11
2019
accepted:
10
02
2020
entrez:
12
3
2020
pubmed:
12
3
2020
medline:
12
3
2020
Statut:
epublish
Résumé
This report presents an unusual case of instrumentation failure after posterior fixation of a C2 fracture and reviews currently available treatment alternatives. The patient, a 53-year-old female, initially presented to the emergency department at an outside facility with acute alcohol intoxication and acute neck pain following a fall from a ladder. CT demonstrated bilateral C2 pars fractures and unstable posteroinferior displacement of the posterior elements. She underwent an emergent C2 open-reduction internal fixation (ORIF) at the outside facility with 3.5 mm polyaxial synapse pedicle screws (DePuy Synthes, Switzerland). There were no known complications and the patient was discharged. Two years after the index operation, cervical CT scan at a different facility revealed that although the fracture was fully healed, bilateral tulip caps had detached from the pedicle screw heads at C2. All implants were removed without postoperative complications. Industry review of alternate lag screws approved for the cervical spine demonstrated that there is not currently an ideal implant for fixation of C2 fractures without fusion. Cannulated trauma screws, which are low profile and would have avoided the instrumentation failure seen here, are not currently FDA approved for the cervical spine.
Identifiants
pubmed: 32158578
doi: 10.1155/2020/5824383
pmc: PMC7060438
doi:
Types de publication
Case Reports
Langues
eng
Pagination
5824383Informations de copyright
Copyright © 2020 Halle E. K. Burley et al.
Déclaration de conflit d'intérêts
The authors declare that there is no conflict of interest regarding the publication of this article.
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