PMC3669469_01
Preoperative CT scan and MRI scan of the cervical spine showing cranio-vertebral junction anomaly with C2-3 subluxation and block C4-C5 vertebra
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F1
A 54-year-old gentleman with cervical compressive spondylotic myelopathy and multiple congenital anomalies of the cervical spine such as cranio-vertebral junction anomaly with occipit-C1 synostosis and C4-C5 fused vertebrae [Figure 1] underwent C3 median corpectomy, gardening, iliac crest graft placement, and stabilization using titanium plate and screws from C2 to C4 vertebral bodies [Figure 2].
Intraoperative X-ray cervical spine lateral view showing implant in situ
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F2
A 54-year-old gentleman with cervical compressive spondylotic myelopathy and multiple congenital anomalies of the cervical spine such as cranio-vertebral junction anomaly with occipit-C1 synostosis and C4-C5 fused vertebrae [Figure 1] underwent C3 median corpectomy, gardening, iliac crest graft placement, and stabilization using titanium plate and screws from C2 to C4 vertebral bodies [Figure 2].
Clinical photo of the patient on 8 years follow-up, showing perforation of the posterior pharyngeal wall. Cervical plate system and missing screw (arrow head) can be seen through the defect. Interlocking screw is seen intact (long arrow)
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F3
On oral examination, there was a defect in the posterior pharyngeal wall, through which cervical plate along with a missed fixation screw and intact self-locking screw was seen [Figure 3].
X-ray cervical spine lateral view showing anterior dislodgement (thick arrows) and migration of the cervical plate (thin arrow) with screw pullout. Second screw is seen missing
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F4
X-ray cervical spine lateral view showed anterior dislodgement and migration of the plate with a missing screw socket [Figure 4].
Plate and screws which were removed. The self-locking screw at upper end is still intact with one missed fixation screw. The lower locking and fixation screws are unscrewed
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F5
The plate was removed in toto after removing the screws [Figure 5].