Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

Abstract EN

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.