Duncan J D, MacDonald J D
Department of Surgery, University of Arizona Health Sciences Center, Tucson, USA.
Neurosurgery. 1998 Jun;42(6):1399-400. doi: 10.1097/00006123-199806000-00138.
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.
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
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.
Broken titanium pedicle screws can be extracted without damaging the pedicle and without using specialized equipment.
描述一种使用高速钻头取出断裂椎弓根螺钉碎片的简单技术，并讨论文献中介绍的其他取出技术。
在椎弓根上方，沿着碎片的长轴并紧邻碎片钻一个导向孔，以取出断裂的椎弓根螺钉。然后将钻头楔入骨与近端螺钉螺纹之间的界面。当钻头压在螺纹上时，以短脉冲方式启动钻头。钻头顺时针旋转与螺纹啮合，将螺钉碎片退出。
该技术已成功应用于至少两名钛螺钉断裂的患者，使同一孔中能够植入更大直径的螺钉。使用的是标准设备，未出现并发症。
可以在不损伤椎弓根且不使用专门设备的情况下取出断裂的钛椎弓根螺钉。
