Extraction of broken pedicle screws: technical note.
OBJECTIVE
To describe a simple technique for extraction of broken pedicle screw fragments using a high-speed drill and to discuss additional extraction techniques presented in the literature.


METHODS
The broken pedicle screw is removed by drilling a pilot hole with a side-cutting bit next to and along the long axis of the fragment in the superior aspect of the pedicle. The bit is then wedged into the interface between the bone and the proximal screw threads. While the bit is pressed against the threads, the drill is activated in brief pulses. The clockwise rotation of the drill bit engages the threads and backs out the screw fragment


RESULTS
This technique has been successfully used in at least two patients with fractured titanium screws allowing placement of larger diameter screws in the same holes. Standard equipment was used, and no complications were encountered.


CONCLUSIONS
Broken titanium pedicle screws can be extracted without damaging the pedicle and without using specialized equipment.
Duncan
J D
JD
Department of Surgery, University of Arizona Health Sciences Center, Tucson, USA.
MacDonald
J D
JD
D001863:Bone Screws / Q000009:adverse effects*; D004868:Equipment Failure; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D009493:Neurosurgery / Q000379:methods*; D012086:Reoperation; D013131:Spine / Q000601:surgery*; D014025:Titanium
D014025:Titanium