Sanden and colleagues [20], in a cohort study of 21 patients who underwent pedicle screw removal surgery, reported that the radiolucent zones around pedicle screws was associated with lower extraction torque, but they did not employ CT scan or evaluate the risk factors for loosening according extraction torque. g No significant difference of extraction torque was found among different screw length. 2012;132(4):4716. The cookie is used to store the user consent for the cookies in the category "Performance". In the fractured vertebrae, the continuity of cortical and structure of trabecula were damaged, which might affect the stability of screw placed in it. Complications and Problems Related to Pedicle Screw Fixation - LWW Should I sue. Two hundred thirty-six pedicle screws were extracted in total, including 86 in thoracic spine, 138 lumbar, and 12 sacral. 5 Is it possible for a screw to come loose? The authors declare that they have no competing interests. He said the CT scan, the MRI and the bone scan showed nothing except the loose screws at the L5 level. Pedicle screw loosening: the value of radiological imagings and the identification of risk factors assessed by extraction torque during screw removal surgery. 2005;10(2):1336. Arch Orthop Trauma Surg. As shown in Tables3 and4, the X-ray criteria of loosening had a sensitivity of 24% and a specificity of 98%, while the CT scan criterion of loosening had a sensitivity of 22% and a specificity of 96%. Screw loosening and multiple prior spinal operations should be suspicious for implant infection after spinal fusion when it comes to revision surgery. Questions Regarding If the Screw Can Be Removed? 4 months after surgery. Therefore, based on our result, CT might not be superior to X-ray in assessment of screw loosening, especially considering its higher cost and radiation exposure. Can you sue for failed back surgery syndrome? Degeneration of the adjacent discs. A general anesthetic is required for spinal fusion. Christensen FB, Dalstra M, Sejling F, Overgaard S, Bunger C. Titanium-alloy enhances bone-pedicle screw fixation: mechanical and histomorphometrical results of titanium-alloy versus stainless steel. In this process, two or more vertebrae are fused together and healed into one solid bone. Eur Spine J. Faraj AA, Webb JK. There was no significant difference in sensitivity (p=0.863) or specificity (p=1.00) between X-ray and CT scan. L2, at that time he took out all my old hardware, "since i am there" was the answer i was told why they took it out. You also have the option to opt-out of these cookies. I had a screw come loose after a spinal fusion and all I felt was more pain as time went on. Heres a quick overview of spinal tumors and where they occur. In a spinal fusion procedure, hardware is typically used to stabilize the spine while the bone graft fuses the vertebrae together.