2213 Spinal Rod Migration and Pelvic Perforation in a Patient with Severe Cerebral Palsy and Scoliosis

Abstract

Video Objective To describe a rare occurrence of spinal hardware migration and perforation into the pelvic peritoneum. To describe the evaluation of the pelvic organs with perforating trauma. Setting Academic university affiliated tertiary care center. Interventions Cerebral palsy refers to a heterogeneous group of conditions involving permanent nonprogressive central motor dysfunction that affect muscle tone, posture, and movement. It can be associated with neuromuscular scoliosis which can cause large curves in the spine and pelvic obliquity necessitating spinal and pelvic fusion and fixation. Hardware failures from these surgeries are rare however do occur with increased incidence in patients with risk factors such as ongoing severe contractures of the spine. Specifically, the Luque rod has been associated with complications and even pelvic cortex perforation. This video describes a rare occurrence of a Luque rod perforation from the spine and bony pelvis into the retroperitoneum and perforation into the pelvis. We show an evaluation of the potential trauma sites and highlight the location of this rod in relation to the surrounding vital pelvic structures. Conclusion We report a rare occurrence of spinal hardware migration and perforation into the pelvic peritoneal cavity. Multispecialty surgical planning and coordination is extremely important. Many contingent surgical plans are necessary prior to the operating room for optimal outcomes.