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Misplaced Cervical Screws Requiring Reoperation.

Jeremy C Peterson1, Paul M Arnold1, Zachary A Smith2

  • 1University of Kansas Medical Center, Kansas City, KS, USA.

Global Spine Journal
|April 29, 2017
PubMed
Summary
This summary is machine-generated.

Screw backout or misplaced screws in cervical spine surgery are rare complications, occurring in 0.085% of cases. While revision surgery may be needed, patients typically do not experience new neurologic deficits.

Keywords:
cervical spinecomplicationfusioninstrumentationmisplaced screwscrew backout

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Cervical spine screw fixation is a common procedure.
  • While generally safe, rare complications like screw backout or misplacement can occur, leading to morbidity and increased healthcare costs.

Purpose of the Study:

  • To report the incidence and outcomes of screw backout and misplacement in cervical spine surgery.
  • To analyze the largest series to date of revision procedures due to screw misplacement.

Main Methods:

  • A multicenter, retrospective case series involving 23 institutions in the United States.
  • Analysis of 12,903 patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011.
  • Inclusion criteria required screw misplacement necessitating reoperation.

Main Results:

  • An incidence of 0.085% for screw backout requiring reoperation was observed (11 cases).
  • No significant changes in health-related quality-of-life metrics or new neurologic deficits were reported.
  • The most frequent site for screw backout was the C6 level (36%).

Conclusions:

  • Screw misplacement requiring revision is a rare complication in cervical spine surgery.
  • Patients undergoing revision surgery for this complication typically do not develop new neurologic deficits but incur increased healthcare costs.
  • Meticulous surgical technique and anatomical knowledge are crucial for preventing these complications.