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Most implant suppliers, and also some third parties, provide specific instrumentation to remove broken screws from implants (i.e., Certain screw removal kit, Biomet 3I, Palm Beach Gardens, United States; screw removal kit NobelReplace, Nobel Biocare, Göteborg, Sweden; Neo screw remover kit, Neobiotech Co, South Korea).
Problems with this type of fixation have been reported and included the following: late syndesmotic widening after screw removal; screw loosening; screw breakage; the need for a second operation to remove the screw; and morbidity associated with prolonged immobilization [5, 9].
This study aimed to improve screw socket design to prevent slippage and difficult screw removal.
In fact, this new technique makes the need for a less invasive method of pedicle screw removal greater now than ever.
Overall, 19 patients needed a non-planned secondary intervention, of which 12 were deemed a minor procedure (e.g. 'dynamisation by distal screw removal').
A method of adjusting fracture alignment after plate placement, without screw removal, presents an improvement over costly and risky revision surgery.
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Reports of driver slippage leading to difficult locking screw removals have increased since the adoption of titanium for screw fabrication; the use of titanium is known to cause cross-threading and cold welding.
Overall, in 32 of 68 patients (47%) secondary surgeries including screw removals were undertaken during follow-up.
The pain resolved 1 day post-screw removal, and within 6 weeks, the common peroneal nerve palsy had resolved.
In another 27 patients (11%), isolated screw(s) removal was performed due to painful prominence of screw head.
To our knowledge, we describe the first acute vertebral compression fracture after percutaneous pedicle screw implant removal in a young man which occurred during an episode of forceful coughing.
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