Retrieval of broken pedicle screws by “friction” technique

Abstract

<jats:p content-type="fine-print">U The authors describe a simple and fast technique for removal of deeply situated broken pedicle screw fragments.</jats:p> <jats:p content-type="fine-print">The screw fragments are removed using a fine-serrated, conically cored bit with a light rough inner surface that is mounted on a common slow-speed drill capable of rotating clockwise and counterclockwise. The cored head of the bit is pressed and engaged on the cut surface of the broken screw, and the drill is made to turn in counterclockwise rotation; this, by means of friction, causes the two surfaces to interlock, and consequently the broken screw fragment backs out. This technique was used to retrieve both broken titanium and stainless steel screws, and satisfying results were obtained. There were no complications associated with the application of the technique, and the pedicle as well as the screw hole were always preserved, offering, in the event that the vertebral instability continued, the possibility of applying a new screw of slightly larger diameter at the same screw hole.</jats:p> <jats:p content-type="fine-print">This technical application offers the opportunity of removing deeply situated screw fragments by using a simple technique while maintaining the vertebral pedicle and screw-hole integrity.</jats:p>

Simple technique for removing broken pedicular screw with plain and serviceable screwdriver

“…Previously, different techniques were introduced for removal of broken pedicular screw [1,2,[4][5][6]. McGuire introduced a screw extractor, which removes the broken screw via a drilled central pilot hole on it [4].…”

“…This technique involves additional resection of pedicle during construction of a pilot hole, and this process may weaken the pedicle. Di Lorenzo et al and Weng et al summarize screw retrieval instruments that are specially designed screw heads, which grasp broken screw and remove it by counter clockwise movement with the help of friction and grasping, respectively [1,6]. These techniques may require wide bone removal of pedicle at the periphery of broken screw to be able to grasp it by these Fig.…”

“…It should be technically easy and noninvasive to pedicle, because any damage to pedicle, during removal of the broken screw, may weaken the pedicle, and this weakness in turn may decrease the success of reinstrumentation. Previously, some techniques were described for removal of broken pedicular screws [1,2,[4][5][6].…”

Simple Technique for Removing Broken Pedicular Screws

“…It has been recognized that pedicle screw fixation in spinal surgery produces a higher rate of fusion compared with other methods [1][2][3][4][5][6] . At the same time it may be associated with a higher rate of complications and so the safety and the effectiveness of pedicle-screw instrumentation have been questioned 3,6 .…”

Easy retrieval of polyaxial tulip-head pedicle screws by “U” rod technique

“…However, there are quite a few patients undergoing implant removal each year either because of implant-related discomfort or implant failure (5-8%) [1][2][3][4].…”