Abstract:
STUDY DESIGN:A report of two cases using custom-manufactured pedicle screws for revision spinal arthrodesis for pseudarthrosis in the setting of widely dilated pedicle screw tracts. OBJECTIVE:To present surgical outcomes of a previously unreported treatment for pseudarthrosis with widely dilated pedicle screw tracts. SUMMARY OF BACKGROUND DATA:Techniques for revision of lumbar pseudarthrosis with severe screw loosening and widely dilated pedicle screw tracts represent a challenging clinical scenario. If stable fixation cannot be achieved, fixation may fail or adjacent normal levels may need to be included in the construct. METHODS:Two patients presenting with painful pseudarthrosis after lumbar spinal fusion and instrumentation loosening with widely dilated pedicle screw tracts were treated with revision anterior and posterior spinal fusion using custom-manufactured large-diameter pedicle screws. RESULTS:In both cases, the custom-manufactured pedicle screws achieved excellent purchase in the dilated pedicle screw tract. Both patients went on to solid fusion at 1 year after surgery. CONCLUSION:This is a previously unreported technique for revision spinal fusion in the setting of loose instrumentation with widely dilated pedicle screw tracts.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Huang RC,Meredith DS,Kepler CK,Tropiano Pdoi
10.1097/BRS.0b013e31820285cfsubject
Has Abstractpub_date
2011-10-15 00:00:00pages
E1489-92issue
22eissn
0362-2436issn
1528-1159journal_volume
36pub_type
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