Colon Perforation Caused by Migration of a Bone Graft Following a Posterior Lumbosacral Interbody Fusion Operation

Abstract

In Brief Study Design. This is a case report. Objective. The purpose was to report a patient whose migrated L4–S1 femur graft led to perforation of the cecum. Summary of Background Data. Autograft bone use during spinal surgery is quite commonplace nowadays. With time due to infection, technical mishaps, or disease recurrence, these autografts may break off their points of attachments and with their subsequent migration lead to serious complications. Methods. The patient who had the history of a stabilization operation performed for his L5–S1 spondylolisthesis grade III by way of a L4–L5, S1 transpedicular rod screw presented with high fever and abdominal tenderness. The patient underwent a laparatomy and a perforation on the medial aspect of the cecum, and a femur graft extending into the cecum through the perforation was found. Results. The graft was removed and the cecum was primarily repaired. The patient was discharged on the 15th postoperative day after an uneventful postoperative course. Conclusion. We have presented a case whose migrated L4–S1 femur graft led to perforation of the cecum. We recommend that frequent radiologic follow-up should be done in patients at risk to show complications early enough to avert severe consequences. Although migration of bone grafts after posterior lumbosacral interbody fusion is rare, intraabdominal complications caused by the migrated graft is even rarer. A case of cecal perforation caused by such a migration is presented, and the importance of frequent follow-up of patients at risk is underscored.