Extraction of broken pedicle screws: technical note.

ABSTRACT

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. TECHNIQUE 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. CONCLUSION: Broken titanium pedicle screws can be extracted without damaging the pedicle and without using specialized equipment.