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Case report
peer-reviewed

Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring



Abstract

Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord. In the present case, the construct was removed and the patient underwent a durotomy repair and a posterior fusion of cervical levels 1 and 2 via screw placement under image guidance with a subsequent functional improvement back to baseline. We report this case and review the literature on the complications associated with cervical wire fusion and the methods of minimizing these risks.



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Case report
peer-reviewed

Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring


Author Information

Hurtis J. Tullos

Department of Neurosurgery, University of Oklahoma Health Sciences Center

Robert G. Briggs Corresponding Author

Department of Neurosurgery, University of Oklahoma Health Sciences Center

Andrew K. Conner

Department of Neurosurgery, University of Oklahoma Health Sciences Center

Allison E. Williams

Department of Neurosurgery, University of Oklahoma Health Sciences Center

John B. Maxwell

Department of Neurosurgery, University of Oklahoma Health Sciences Center

Michael D. Martin

Department of Neurosurgery, University of Oklahoma Health Sciences Center


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring


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Case report
peer-reviewed

Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring

  • Author Information
    Hurtis J. Tullos

    Department of Neurosurgery, University of Oklahoma Health Sciences Center

    Robert G. Briggs Corresponding Author

    Department of Neurosurgery, University of Oklahoma Health Sciences Center

    Andrew K. Conner

    Department of Neurosurgery, University of Oklahoma Health Sciences Center

    Allison E. Williams

    Department of Neurosurgery, University of Oklahoma Health Sciences Center

    John B. Maxwell

    Department of Neurosurgery, University of Oklahoma Health Sciences Center

    Michael D. Martin

    Department of Neurosurgery, University of Oklahoma Health Sciences Center


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: February 14, 2018

    DOI

    10.7759/cureus.2191

    Cite this article as:

    Tullos H J, Briggs R G, Conner A K, et al. (February 14, 2018) Myelopathy Improvement Following Removal of Cervical Sublaminar Wiring. Cureus 10(2): e2191. doi:10.7759/cureus.2191

    Publication history

    Received by Cureus: December 29, 2017
    Peer review began: January 03, 2018
    Peer review concluded: February 11, 2018
    Published: February 14, 2018

    Copyright

    © Copyright 2018
    Tullos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Posterior cervical wiring has been used by spine surgeons in fixation procedures for patients with spinal instability. It is historically considered an effective method of treating cervical instability with a low risk of complications leading to neurological deterioration. We experienced a case of delayed neurological decline associated with myelopathy, lower extremity spasticity, and associated syringomyelia secondary to instrumentation failure and resultant sublaminar wire protrusion into the cervical spinal cord. In the present case, the construct was removed and the patient underwent a durotomy repair and a posterior fusion of cervical levels 1 and 2 via screw placement under image guidance with a subsequent functional improvement back to baseline. We report this case and review the literature on the complications associated with cervical wire fusion and the methods of minimizing these risks.



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