What is it about?

A 64-year-old man received a titanium rib implant during lung cancer surgery to rebuild his chest wall. About six weeks later, he came to the emergency department with an extremely severe headache and uncontrollable vomiting. Scans revealed that air had collected both around his brain (pneumocephalus) and along his spinal canal (pneumorrhachis). Doctors discovered that the rib implant had slowly worn through the membrane covering his spinal cord, allowing air to enter spaces where it does not belong. They removed the implant, repaired the tear, and the patient fully recovered without lasting problems. This report shows that even though titanium rib implants are generally safe, they can sometimes cause delayed complications by eroding into nearby tissues. Knowing about this possibility can help clinicians recognize similar problems earlier and treat them quickly, improving patient outcomes.

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Why is it important?

First Report of Its Kind: This is one of the first documented cases where a titanium rib implant caused both pneumocephalus and pneumorrhachis weeks after surgery, highlighting a rare but serious risk. Improves Early Detection: By sharing detailed clinical signs—sudden, severe headache and vomiting without trauma—this work equips emergency and surgical teams to consider imaging for air collections when patients present late symptoms after thoracic implants. Guides Safer Implant Use: Understanding that even biocompatible materials like titanium can erode into the spinal canal underscores the need for long-term monitoring and careful placement techniques during chest wall reconstructions.

Perspectives

We write this case report and literature review to raise awareness among fellow clinicians that delayed neurological complications can occur even after routine chest wall reconstructions. Discovering the implant erosion on imaging and seeing the patient recover fully after timely intervention reinforced for us how vigilant we must be when novel findings emerge. Sharing this experience is our way of contributing to safer surgical practice and encouraging colleagues to report similar cases, so we all learn to anticipate these rare but critical events.

Yusuf Koksal
Primary Health Care Corp

Read the Original

This page is a summary of: Pneumocephalus and Pneumorrhachis Following Titanium Rib Implant: A Case Report and Literature Review, Current Medical Imaging Formerly Current Medical Imaging Reviews, March 2025, Bentham Science Publishers,
DOI: 10.2174/0115734056375842250109093802.
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