Related Experiment Video
Updated: Jun 4, 2026
An Anesthesia, Surgery, and Harvest Method for the Evaluation of Transpedicular Screws Using an In Vivo Porcine Lumbar Spine Model
Published on: May 31, 2017
Salvage of lumbar pseudarthrosis with customized large-diameter pedicle screws: report of two cases
Russel C Huang1, Dennis S Meredith, Christopher K Kepler
1Hospital for Special Surgery, Weill Cornell Medical Center, Department of Orthopaedic Surgery, Spine & Scoliosis Service, NY, NY 10021, USA.
Study Design:
A report of two cases using custom-manufactured pedicle screws for revision spinal arthrodesis for pseudarthrosis in the setting of widely dilated pedicle screw tracts.
Objective:
To present surgical outcomes of a previously unreported treatment for pseudarthrosis with widely dilated pedicle screw tracts.
Summary Of Background Data:
Techniques for revision of lumbar pseudarthrosis with severe screw loosening and widely dilated pedicle screw tracts represent a challenging clinical scenario. If stable fixation cannot be achieved, fixation may fail or adjacent normal levels may need to be included in the construct.
Methods:
Two patients presenting with painful pseudarthrosis after lumbar spinal fusion and instrumentation loosening with widely dilated pedicle screw tracts were treated with revision anterior and posterior spinal fusion using custom-manufactured large-diameter pedicle screws.
Results:
In both cases, the custom-manufactured pedicle screws achieved excellent purchase in the dilated pedicle screw tract. Both patients went on to solid fusion at 1 year after surgery.
Conclusion:
This is a previously unreported technique for revision spinal fusion in the setting of loose instrumentation with widely dilated pedicle screw tracts.
