title: An innovative universal screw removal instrument.
abstract: OBJECTIVE
  To present the clinical benefits of an instrument designed to facilitate removal of polyaxial screws during revision surgery.
  
  
  METHODS
  All polyaxial screws can be removed without additional materials or a large amount of debridement using our newly designed instrument. Forty-two screws were removed from five patients without any complications using this instrument.
  
  
  RESULTS
  We removed the cap screws and rods from the 42 polyaxial screws in five patients and made them monoaxial using the new screw removal apparatus. The screws and rods were removed quickly in a minimally invasive way with no complications. No damage to the pedicle or surrounding soft tissue occurred during screw removal. No neurogenic changes developed during revision surgery after changing the screws.
  
  
  CONCLUSIONS
  This newly designed screw removal instrument was used safely and effectively to remove all polyaxial and monoaxial pedicle screws.
authors.affiliation: Department of Orthopaedics and Traumatology, Bezmialem Vakıf University School of Medicine, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Elmadağ
authors.affiliation: Department of Orthopaedics and Traumatology, Ordu University School of Medicine, Ordu, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Güzel
authors.affiliation: Department of Orthopaedics and Traumatology, Bezmialem Vakıf University School of Medicine, Istanbul, Turkey.
authors.forename: Gökçer
authors.initials: G
authors.lastname: Uzer
authors.affiliation: Department of Orthopaedics and Traumatology, Selçuk University Selçuklu School of Medicine, Konya, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Acar
keywords: Equipment failure; Pedicle screws; Spinal fusion; Spine