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

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Hafez , A , Ibrahim , T F , Raj , R , Antinheimo , J , Siironen , J & Hernesniemi , J 2016 , ' Delayed Migration of Fractured K-wire Causing Vertebral Artery Invagination After Anterior Atlantoaxial Fixation : A Case Report ' , World Neurosurgery , vol. 88 , ARTN 695.E5 . https://doi.org/10.1016/j.wneu.2015.12.082

Title: Delayed Migration of Fractured K-wire Causing Vertebral Artery Invagination After Anterior Atlantoaxial Fixation : A Case Report
Author: Hafez, Ahmad; Ibrahim, Tarik F.; Raj, Rahul; Antinheimo, Jussi; Siironen, Jari; Hernesniemi, Juha
Contributor: University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2016-04
Language: eng
Number of pages: 6
Belongs to series: World Neurosurgery
ISSN: 1878-8750
URI: http://hdl.handle.net/10138/223997
Abstract: BACKGROUND: Most of the physician's attention during spinal surgery, when using wires and screws, is toward the avoidance of injuries of critical structures (nerves and vessels). When such 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 of broken Kirschner wire (K-wire) are well known in literature; however, to the best of our knowledge, migration of a fractured K-wire during anterior atlantoaxial fixation of cervical spine has not been reported in the literature. CASE DESCRIPTION: We report a case in which a fractured K-wire was imbedded in the lateral mass of C1 for 3 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 extracted successfully. In our case, with optimal follow-up, the burred wire inside hard bone was moved in delayed fashion to come out of the bone, grooving the dominant vertebral artery. CONCLUSIONS: Our recommendation is to inspect the K-wire before using it and to try retrieve as much as possible when removing it.
Subject: Atlantoaxial fixation
K-wire migration
Vertebral artery
TRANSARTICULAR SCREW FIXATION
FAILED ODONTOID FIXATION
POLYAXIAL SCREW
KIRSCHNER WIRE
COMPLICATION
SALVAGE
INJURY
FUSION
SYSTEM
3112 Neurosciences
3126 Surgery, anesthesiology, intensive care, radiology
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