Abstract
Case:We report a patient with permanent tracheostomy in the context of muscular dystrophy presented for pneumonia. On bronchoscopy, a pedicle screw was seen penetrating the trachea. Computed tomography revealed significant anterior erosion of the T1-T3 vertebrae due to chronic pressure injury from the tracheostomy cuff, exposing pedicle screws implanted >10 years earlier. The patient was fitted for a custom low-pressure cuff. No further sequelae developed for 4 months.Conclusion:To the best of our knowledge, this is the first case of exposed spinal fusion instrumentation due to chronic vertebral erosion. Early sagittal imaging and the use of low-pressure cuffs may help prevent this complication.
| Original language | English |
|---|---|
| Article number | e22.00310 |
| Journal | JBJS case connector |
| Volume | 12 |
| Issue number | 3 |
| DOIs | |
| State | Published - Aug 12 2022 |
Keywords
- adolescent
- DMD
- Duchenne muscular dystrophy
- instrumentation
- ischemic osteonecrosis
- long-term tracheostomy
- mechanical ventilation
- pedicle screw
- posterior spinal fusion
- pressure injury
- scalloped erosion
- scoliosis
- tracheostomy
- tracheostomy cuff balloon
- ventilator dependence
- vertebral destruction
- vertebral erosion
- young adult