North American Spine Society journal · 2026
Use of a metal cutting wheel burr and osteotome as a screwdriver to remove embedded broken pedicle screws in the revision of a high-grade spondylolisthesis: a technical case report.
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Lewis Stephen J, Oitment Colby T A, Nielsen Christopher J, Jentzsch Thorsten
Аннотация
BACKGROUND: There are limited studies describing the feasible removal of broken pedicle screws. A surgical technique demonstrating the removal of broken sacral pedicle screws using commonly available instruments in a patient treated for high grade spondylolisthesis is illustrated in this report.
METHODS: A 15-year-old female patient underwent uncomplicated revision spondylolisthesis correction at L5/S1 with revision decompression, implant removal including bilateral S1 broken screws and L4-pelvis instrumented fusion for pseudarthrosis and persistent L5 radiculopathy. The broken S1 screws were not removable with the standard broken screw removal kit. A groove was cut into the top of the retained shaft of the screw using a metal cutting wheel burr. An osteotome was then used to unscrew the remaining fragments of the retained S1 screws.
RESULTS: The broken pedicle screws were successfully removed.
CONCLUSIONS: This technical note provides a useful tip for spine surgeons illustrating a method to remove broken pedicle screws with a wheel burr and osteotome. With the large volumes of spinal fusion revisions required and the great variability of different instrumentation systems utilized, innovative techniques with commonly available instruments may be required in removing implants.
METHODS: A 15-year-old female patient underwent uncomplicated revision spondylolisthesis correction at L5/S1 with revision decompression, implant removal including bilateral S1 broken screws and L4-pelvis instrumented fusion for pseudarthrosis and persistent L5 radiculopathy. The broken S1 screws were not removable with the standard broken screw removal kit. A groove was cut into the top of the retained shaft of the screw using a metal cutting wheel burr. An osteotome was then used to unscrew the remaining fragments of the retained S1 screws.
RESULTS: The broken pedicle screws were successfully removed.
CONCLUSIONS: This technical note provides a useful tip for spine surgeons illustrating a method to remove broken pedicle screws with a wheel burr and osteotome. With the large volumes of spinal fusion revisions required and the great variability of different instrumentation systems utilized, innovative techniques with commonly available instruments may be required in removing implants.