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Iatrogenic peritonitis following an incident during ablation of a pedicle screw

P Cottin1, N Mebtouche1, G Pourcher2

  • 1Service d'orthopédie, traumatologie et chirurgie reconstructrice, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|January 23, 2018
PubMed

Insights

A migrated pedicle screw during spine surgery removal caused internal injuries. This rare complication highlights the need for careful technique to prevent serious patient harm.

Area of Science:

  • Spinal surgery
  • Surgical complications
  • Medical device migration

Background:

  • Spinal fusion and ablation procedures carry risks.
  • Complications from material implantation are known.
  • Spinal material ablation complications are undocumented.

Observation:

  • A case of intraperitoneal pedicle screw migration during attempted removal is presented.
  • The screw migrated through the psoas muscle.
  • The screw perforated a loop of the small intestine.

Findings:

  • The migration led to hemorrhagic shock and peritonitis.
  • Initial extra-pedicular screw placement was a contributing factor.
  • Excessive force during removal exacerbated the incident.

Implications:

  • This case underscores the potential for severe complications during spinal device removal.
  • Preventive measures focusing on accurate screw placement and careful removal techniques are crucial.
  • Understanding migration mechanisms can improve patient safety in spinal procedures.
Keywords:
Material ablationPedicle breakagePedicle screwPeritonitis

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