Delayed Surgical Site Infection with Progressive Myelopathy Following Hydroxyapatite Spacer Dislodgement in Double-Door Laminoplasty

CASE: A 73-year-old gentleman presented with clinical features of progressive cervical myelopathy for a month. He underwent C3-C6 double-door laminoplasty with a hydroxyapatite (HA) spacer 16 years ago. Magnetic resonance imaging scan revealed a delayed infection at the laminoplasty site, along with dislodgement of the HA spacers. He underwent thorough surgical debridement with removal of the spacers, followed by an appropriate antibiotic regimen based on culture sensitivity pattern. CONCLUSION: Delayed infection following HA spacer dislodgement is a rare event, causing progressive myelopathy in laminoplasty. However, it can be effectively treated by timely diagnosis followed by thorough debridement, complete removal of spacers, and appropriate antibiotic management.