case_images: PMC3669469_01
case_images: Preoperative CT scan and MRI scan of the cervical spine showing cranio-vertebral junction anomaly with C2-3 subluxation and block C4-C5 vertebra
case_images: JCVJS-3-19-g001.jpg
case_images: PMC3669469_01_JCVJS-3-19-g001.jpg
case_images: F1
case_images: 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].
case_images: Intraoperative X-ray cervical spine lateral view showing implant in situ
case_images: JCVJS-3-19-g002.jpg
case_images: PMC3669469_01_JCVJS-3-19-g002.jpg
case_images: F2
case_images: 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].
case_images: 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)
case_images: JCVJS-3-19-g003.jpg
case_images: PMC3669469_01_JCVJS-3-19-g003.jpg
case_images: F3
case_images: 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].
case_images: 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
case_images: JCVJS-3-19-g004.jpg
case_images: PMC3669469_01_JCVJS-3-19-g004.jpg
case_images: F4
case_images: X-ray cervical spine lateral view showed anterior dislodgement and migration of the plate with a missing screw socket [Figure 4].
case_images: 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
case_images: JCVJS-3-19-g005.jpg
case_images: PMC3669469_01_JCVJS-3-19-g005.jpg
case_images: F5
case_images: The plate was removed in toto after removing the screws [Figure 5].