Dislodged upper thoracic cage in the gastrointestinal tract: a case report and literature reviews.

Abstract

A rare case of esophageal perforation secondary to a dislodged upper thoracic cage found by the gastrointestinal endoscope is presented. To report an extremely rare complication of upper thoracic vertebral tuberculosis treated with corpectomy and interbody cage surgery and suggest the cause, mechanism, and outcome of the complication of esophageal perforation. Tuberculotic spondylitis often affects the anterior column of the spine and surgery is indicated in the presence of an epidural abscess, neurologic deficits secondary to compression of the spinal cord, bone destruction with instability, or failure of antituberculous therapy. Surgical treatment requires radical debridement followed by anterior stabilization. A controversy exists regarding the use of the instrumentation in the tuberculous spine. Retrospective case study and literature review. Because of the concomitant medical problems and little deterioration of the neurologic function, our patient is managed uneventfully with conservative treatment. To the authors' knowledge, this is an extremely rare reported complication of upper thoracic cage surgery for vertebral tuberculosis. This case demonstrates that the cage migration in the tuberculous spondylitis might have a rather benign clinical course and structural bone grafting or interbody cage insertion without supplemental instrument fixation seems to be inadequate.