Delayed Migration of Fractured K-wire Causing Vertebral Artery Invagination Following Anterior Atlantoaxial Fixation: A Case Report.

Delayed Migration of Fractured K-wire Causing Vertebral Artery Invagination Following Anterior Atlantoaxial Fixation: A Case Report.

World Neurosurg. 2015 Dec 31;

Authors: Hafez A, Ibrahim T, Raj R, Antinheimo J, Siironen J, Hernesniemi J

Abstract
Most of attention during spinal surgery, when using wires and screws, is going to avoid injuries of the critical structures (nerves and vessels). When these wires are broken during surgery, the most important point is to take them out safely or, if it is impossible, to leaf them in secure place and follow the patient closely. Migrations broken k-wire is well known in literature. However, to the best of our knowledge, migration fractured K-wire during anterior atlantoaxial fixation of cervical spine is not reported in the literature. We report a case in which a fractured k-wire has been imbedded in the lateral mass of C1 for three years and then migrated to endanger the dominant right vertebral artery. By using posterior approach and drilling right part of posterior arch of C1 we manage to secure the vertebral artery. The broken k-wire was successfully extracted away. In our case, with optimal follow-up, the burred wire inside hard bone has been moved in delayed fashion to come out of the bone and grooving the dominant vertebral artery. Our recommendation is to investigate the k-wire in every attempt of using it and to try as much as we can when to take it out immediately.

PMID: 26748177 [PubMed - as supplied by publisher]

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