Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

• Published in: Case reports in medicine Vol. 2017; no. 2017; pp. 1 - 4
• Main Authors: Radl, R., Sadoghi, Patrick, Bratschitsch, G., Gilg, M. M., Brückmann, C. I., Leitner, L., Leithner, Andreas
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01-01-2017; Hindawi; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Care and treatment; Case Report; Case studies; Fractures; Internal fixation in fractures; Austria
• ISSN: 1687-9627; 1687-9635
• DOI: 10.1155/2017/2923696

Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.