Late complication after single-rod instrumentation.

Abstract

A case report of late complication after single-rod instrumentation. To report a case of symptomatic, perispinal, soft-tissue complication after successful fusion of a scoliotic curve using a unilateral, posterior, multiple hook-rod construct. Delayed perispinal soft-tissue complications recently have been observed with two-rod, multihook system constructs. The etiology is believed to be low, virulence bacteria causing delayed infection, or metal fretting causing chronic inflammation. This phenomenon has not been linked to single-rod constructs. The observation of perispinal soft-tissue inflammation was made during exploratory surgery for progressive pain overlying the rod. The diagnosis was supported by laboratory findings. Complete pain relief was obtained after removal of the hardware and empiric treatment with an oral antibiotic. Delayed chronic inflammation may occur as a late complication of the use of a unilateral, posterior, multiple hook-rod construct in the spine. This problem can be managed successfully with hardware removal, and, because the etiology of this type of inflammation is unclear, infection with a low virulence organism should be considered.