caa a22 4500 445833513 CHVBK 20180317145323.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-011-1696-7 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1696-7 Perforation of the sigmoid colon due to intradiscal spacer dislocation [Elektronische Daten] [Michael Ruf, Andreas Voigt, Dieter Kupczyk-Joeris, Harry Merk] A case of late dislocation of a disc spacer L5/S1 with perforation of the sigmoid colon and transanal passage 4years after implantation is reported. The objective is to describe an uncommon complication of anterior endoscopic spondylodesis L5/S1. To our knowledge, this is the first report on this rare complication. A 39-year-old patient suffering from a spondylolisthesis L5/S1 (Meyerding grade 2) with bilateral lysis L5 was operated with posterior instrumentation L5/S1 and anterior endoscopic insertion of two disc spacers. 4years after surgery the patient noticed one of the spacers in the toilet. Radiographic examination of the colon with contrast dye revealed a perforation at the distal sigmoid colon. At the lumbosacral junction there was a bony defect at the site of the absent spacer and an anterior dislocation of the second spacer. A partial resection of the colon at the perforation site with end-to-end anastomosis was performed. The second spacer was removed, and the defect was packed with autologous cancellous bone and local antibiotics. The further course was uneventful. 2weeks postoperatively the patient was discharged without signs of infection. The radiographic examination after 6months showed healing of the bone graft with bony fusion L5/S1. In case of incomplete or absent bony fusion the dislocation of intradiscal spacers may arise even years after the primary surgery. In consequence periodical radiographic examinations of spinal instrumentations are recommended until complete bony fusion occurred. Unclear abdominal symptoms following anterior spine surgery require immediate examination. Springer-Verlag, 2011 Colon perforation nationallicence Anterior spine surgery nationallicence Minimal invasive nationallicence Spacer dislocation nationallicence Ruf Michael Department of Orthopaedics and Traumatology, Zentralklinikum Suhl, Albert-Schweitzer-Str. 2, 98527, Suhl, Germany aut Voigt Andreas Department of Orthopaedics and Traumatology, Zentralklinikum Suhl, Albert-Schweitzer-Str. 2, 98527, Suhl, Germany aut Kupczyk-Joeris Dieter Clinic for Abdominal Surgery, Zentralklinikum Suhl, Suhl, Germany aut Merk Harry Clinic for Orthopaedic Surgery, Ernst Moritz Arndt University, Greifswald, Germany aut European Spine Journal Springer-Verlag 20(2011-07-01), 289-293 0940-6719 20<289 2011 20 586 https://doi.org/10.1007/s00586-011-1696-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1696-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ruf Michael Department of Orthopaedics and Traumatology, Zentralklinikum Suhl, Albert-Schweitzer-Str. 2, 98527, Suhl, Germany aut NATIONALLICENCE 700 1- Voigt Andreas Department of Orthopaedics and Traumatology, Zentralklinikum Suhl, Albert-Schweitzer-Str. 2, 98527, Suhl, Germany aut NATIONALLICENCE 700 1- Kupczyk-Joeris Dieter Clinic for Abdominal Surgery, Zentralklinikum Suhl, Suhl, Germany aut NATIONALLICENCE 700 1- Merk Harry Clinic for Orthopaedic Surgery, Ernst Moritz Arndt University, Greifswald, Germany aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-07-01), 289-293 0940-6719 20<289 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer