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Extraction of broken pedicle screws: technical note

J D Duncan1, J D MacDonald

  • 1Department of Surgery, University of Arizona Health Sciences Center, Tucson, USA.

Neurosurgery
|June 19, 1998
PubMed
Summary

A novel technique effectively extracts broken pedicle screws using a high-speed drill, avoiding pedicle damage. This simple method allows for the placement of larger screws without specialized equipment.

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Area of Science:

  • Spinal Surgery
  • Orthopedic Devices
  • Biomedical Engineering

Background:

  • Pedicle screw fixation is a common spinal fusion technique.
  • Implantation or removal of pedicle screws can lead to fragment fractures.
  • Retrieval of fractured screw fragments can be challenging.

Purpose of the Study:

  • To present a straightforward method for extracting fractured pedicle screw fragments.
  • To discuss the efficacy of this technique in clinical practice.
  • To review existing literature on broken screw retrieval.

Main Methods:

  • A pilot hole is drilled adjacent to the screw fragment along its long axis.
  • A side-cutting bit is engaged with the screw threads.
  • The drill is pulsed clockwise to back out the fragment.

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Main Results:

  • The technique successfully extracted fractured titanium screws in two patients.
  • Larger diameter screws were placed in the same bone defects.
  • Standard surgical equipment was utilized without complications.

Conclusions:

  • This technique offers a simple and effective solution for fractured pedicle screws.
  • It avoids pedicle damage and the need for specialized retrieval tools.
  • It facilitates revision surgery by allowing for larger screw placement.