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Simple New Screw Insertion Technique without Extraction for Broken Pedicle Screws.
1Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea.
World Neurosurgery
|November 29, 2017
Summary
A novel technique simplifies managing broken spinal pedicle screws without extraction. This method avoids special instruments and adjacent pedicle drilling, enabling new screw placement.
Area of Science:
- Spinal surgery
- Orthopedic surgery
- Neurosurgery
Background:
- Spinal transpedicular screw fixation is a common procedure.
- Broken pedicle screws occur in 3%-7.1% of cases.
- Existing broken screw removal techniques often require specialized instruments.
Purpose of the Study:
- To describe a simple, modified technique for managing broken pedicle screws without extraction.
- To present a method that does not require special instruments or drilling into an adjacent pedicle.
Main Methods:
- Utilized a high-speed air drill with a round burr under C-arm fluoroscopy guidance.
- Palpated the broken screw fragment through the entry hole using a free-hand technique.
- Drilled the distal fragment to create space for a new screw insertion alongside the retained fragment.
Main Results:
- Successfully treated three patients using the modified technique.
- Achieved successful new pedicle screw fixation in all cases.
- Observed no complications, including screw loosening, dural tears, or nerve root injury.
Conclusions:
- A simple, modified technique for managing broken pedicle screws without extraction has been presented.
- This technique is effective and recommended when new screw insertion is necessary.
- The method avoids the need for specialized instruments and adjacent pedicle manipulation.
