A Simple Versatile Technique to Retrieve Polyaxial Tulip-head Spinal Pedicle Screws Following Failed Pedicle Screw Removal: A Technical Note With Analysis of Efficacy and Outcomes

We describe a simple yet versatile technique to remove polyaxial tulip-head pedicle screws using commonly available instruments in the spinal instrumentation set. Materials and Methods: Polyaxial screws were removed after converting them into monoblock screws using the appropriate set-screw screwdriver, a 25-mm long 5.5 mm rod, and a counter torque wrench. Results: Using this technique we have successfully removed 167 screws in 53 revision surgeries [instrumented fusions for lumbar degenerative diseases (n=21), thoracolumbar fractures (n=15), and scoliosis (n=17)]. No failed retrievals or complications like pedicle breach or neurological deficit were observed. Discussion: The described technique is simple to execute, effective, quick, and safe. It is versatile and can be used to remove polyaxial pedicle screws of any design in the thoracic and lumbar spine using the commonly available instruments in the routine spinal instrumentation set (appropriate set-screw screwdriver, a 25-mm long 5.5 mm rod, a counter torque wrench).
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research