Migration of laminar hook causing thoracic myelopathy eight years post scoliosis surgery: a case report.

Abstract

Case report. A case report describing late presentation of neurologic injury with latent infection following scoliosis surgery. Neurologic injury is a well described complication of scoliosis surgery. Late presentations of neurologic injury are rare but have been reported. To our knowledge, there are no reports of late presenting thoracic cord compression from a Cotrel-Dubousset type hook and rod instrumentation associated with latent indolent infection. A 23-year-old man, 8 years status post T3-L3 posterior spinal fusion for scoliosis, presented with approximately a 6-month history of progressive leg numbness and mild weakness. Computed tomography myelogram showed cord compression from a laminar hook at T10 on the left side. The patient's neurologic status improved after device removal. Intraoperative tissue cultures grew coagulase-negative Staphylococci despite having normal preoperative laboratory data for infection. We report a case of late presenting neurologic injury from migration of a laminar hook causing thoracic cord compression and myelopathy. Removal of device resulted in discovery of a latent infection and satisfactory neurologic recovery.