The anterior cervical discectomy and fusion (ACDF) technique is the gold-standard treatment for myeloradiculopathy. We present the case of a seventy-five years old female who came to revision because of worsening solids dysphagia, dry cough, and foreign body sensation in the past two weeks; we had practiced her an ACDF procedure four years ago. She denied presenting neurological deficit or neck pain. The physical examination was normal. Cephalic migration of the left C3 screw was evident on cervical plain and dynamic films and CT-Scan. She was admitted to the hospital for an upper gastrointestinal endoscopy that visualized retropharyngeal ulceration. Thirty minutes before surgery, she presented a spontaneous cough reflex and expelled the screw through her mouth; An esophagogram with a swallow of Bario showed no leakage of the contrast medium. She was under hospital surveillance for five days with prophylactic parenteral nutrition, progressing to a soft diet and later a regular diet. She was discharged home without a new surgery.
Cervical screw loosening has been reported as a rare complication, either due to poor placement or due to the patient's osteoporosis. This case report describes an innocuous spontaneous expectoration of a C3 loosened screw and the diagnostic, therapeutic approach we carried after this event.
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Reyes Rodriguez, Gerson; Alberto Israel Romero Rangel, José; Soto García, Manuel; Rodriguez Garcia, Manuel; David Lopez Garcia, Victor; Tatiana Montes González, Iris; and Antonio Soriano Sánchez, José
"Innocuous expectoration of an anterior C3 loosened screw—case report and literature review about a benevolent evolution with no esophageal injury,"
Archives of Neurosurgery: Vol. 1:
2, Article 9.
Available at: https://www.ansjournal.org/home/vol1/iss2/9