Migration and Spontaneous Extrusion of a Lumbar Spinal Fusion Rod From the Gluteal Region

Abstract

Instrumented fusion with rods and pedicle screws is often performed for the surgical treatment of adult spinal deformity (ASD). One of the complications of such long construct fusions is that of pseudoarthrosis, which can present with implant loosening, failure, and rod breakage. However, migration and spontaneous extrusion of the rod is relatively rare and has yet to be reported in the literature. We report a gentleman with previous long construct instrumented fusion done six years ago for ASD, who presented with gluteal pain. Radiographs revealed rod breakage and caudal migration towards the left gluteal region. He subsequently reported spontaneous extrusion of the broken rod through the gluteal skin, without the need for surgical removal. This case is reported for its rarity and to raise awareness about the rare occurrence of rod migration after breakage that can lead to potential complications if left unattended.