Management of Iatrogenic Spinal Stenosis Complicating Placement of a Fusion Cage

STUDY DESIGN: A case of iatrogenic spinal stenosis secondary to fusion cage retropulsion is presented. OBJECTIVES: To highlight fusion cage retropulsion, a potential complication that may become more prevalent as the use of fusion cage instrumentation expands. The difficulty in management of this complication is emphasized. SUMMARY OF BACKGROUND DATA: Early reports regarding fusion cage instrumentation have been encouraging. At this point, however, the potential benefits are better defined than the potential complications. METHODS: A significant complication of fusion cage instrumentation and the limited literature on this subject are reviewed. RESULTS: The patient underwent successful revision surgery after retropulsion of a fusion cage, however, an extensive surgical procedure including partial vertebral body resection was required. CONCLUSIONS: The frequency and severity of complications related to fusion cage instrumentation remain poorly defined. Caution should be used in patient selection until additional experience more clearly defines the risk-to-benefit ratio for a given application of this new technology.