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Implant removal after posterior stabilization of the thoraco-lumbar spine

  • Orthopaedic Outcome Assessment
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Implant removal because of pain after posterior fusion in the thoracic and lumbar spine is a widely performed operation. We conducted a retrospective study to examine whether patients benefit from implant removal.

Patients and methods

57 patients (29 males, 28 females, mean age 46.5 years) who have undergone removal of pedicle screws because of pain and discomfort were interviewed 6–24 months postoperatively. Fracture was the initial diagnosis in 40% of the patients and degenerative spine disease in 58%. The following factors were evaluated: patient satisfaction and postoperative outcome, patients’ native language and psychological background, operative data, hospital stay and complications.

Results

Pain decreased significantly from 62 to 48 on visual analogue scale postoperatively. Complications occurred in five patients (8.8%). 36 patients (61%) stated they had some benefit from the operation, but only seven patients (12%) were free of pain completely. 36 patients (63%) would undergo the same procedure again. Outcome in the subgroup of foreigners was significantly worse, though the psychological background did not affect the outcome. Preoperative diagnostic infiltration was helpful in 9 of 13 patients.

Conclusion

Removal of pedicle screws because of back pain may be effective, but complete remission of symptoms could be achieved in only 12% of patients. However, 63% of patients would undergo hardware removal again. Preoperative diagnostic infiltration can help to predict the outcome but results are inconsistent. Communication difficulties may worsen the outcome. Surgeons should consider these results when planning implant removal and patients should be informed thoroughly to avoid too high expectations.

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References

  1. Bostman O, Pihlajamaki H (1996) Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units. J Trauma 41(5):846–849

    Article  CAS  PubMed  Google Scholar 

  2. Brown RM, Wheelwright EF, Chalmers J (1993) Removal of metal implants after fracture surgery—indications and complications. J R Coll Surg Edinb 38(2):96–100

    CAS  PubMed  Google Scholar 

  3. Richards RH, Palmer JD, Clarke NM (1992) Observations on removal of metal implants. Injury 23(1):25–28

    Article  CAS  PubMed  Google Scholar 

  4. Sanderson PL, Ryan W, Turner PG (1992) Complications of metalwork removal. Injury 23(1):29–30

    Article  CAS  PubMed  Google Scholar 

  5. Deckey JE, Court C, Bradford DS (2000) Loss of sagittal plane correction after removal of spinal implants. Spine 25(19):2453–2460

    Article  CAS  PubMed  Google Scholar 

  6. Wild A, Pinto MR, Butler L, Bressan C, Wrobleswski JM (2003) Removal of lumbar instrumentation for the treatment of recurrent low back pain in the absence of pseudarthrosis. Arch Orthop Trauma Surg 123(8):414–418

    Article  PubMed  Google Scholar 

  7. Alanay A, Vyas R, Shamie AN, Sciocia T, Randolph G, Wang JC (2007) Safety and efficacy of implant removal for patients with recurrent back pain after failed degenerative lumbar spine surgery. J Spinal Disord Tech 20(4):271–277

    Article  PubMed  Google Scholar 

  8. Vanichkachorn JS, Vaccaro AR, Cohen MJ, Cotler JM (1997) Potential large vessel injury during thoracolumbar pedicle screw removal. A case report. Spine 22(1):110–113

    Article  CAS  PubMed  Google Scholar 

  9. Waelchli B, Min K, Cathrein P, Boos N (2002) Vertebral body compression fracture after removal of pedicle screws: a report of two cases. Eur Spine J 11(5):504–506

    Article  PubMed  Google Scholar 

  10. Potter BK, Kirk KL, Shah SA, Kuklo TR (2006) Loss of coronal correction following instrumentation removal in adolescent idiopathic scoliosis. Spine 31(1):67–72

    Article  PubMed  Google Scholar 

  11. Rathjen K, Wood M, McClung A, Vest Z (2007) Clinical and radiographic results after implant removal in idiopathic scoliosis. Spine 32(20):2184–2188

    Article  PubMed  Google Scholar 

  12. Johnson D, Tucci M, McGuire R, Hughes J (1996) Evaluation of the biomaterial-interface of screw threads in patients having clinical pain. Biomed Sci Instrum 32:127–133

    CAS  PubMed  Google Scholar 

  13. Hume M, Capen DA, Nelson RW, Nagelberg S, Thomas JC Jr (1996) Outcome after Wiltse pedicle screw removal. J Spinal Disord 9(2):121–124

    Article  CAS  PubMed  Google Scholar 

  14. Gaine WJ, Andrew SM, Chadwick P, Cooke E, Williamson JB (2001) Late operative site pain with isola posterior instrumentation requiring implant removal: infection or metal reaction? Spine 26(5):583–587

    Article  CAS  PubMed  Google Scholar 

  15. Collins I, Wilson-MacDonald J, Chami G, Burgoyne W, Vineyakam P, Berendt T et al (2008) The diagnosis and management of infection following instrumented spinal fusion. Eur Spine J 17(3):445–450

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. First Orthopaedic Department, G. Papanikolaou Gen. Hospital, Aristotle University of Thessaloniki, Exohi, Thessaloniki, Greece

    Stavros I. Stavridis

  2. Department of Orthopedic Surgery, St Elisabeth-Hospital Herten, Herten, Germany

    Petra Bücking

  3. Center for Musculoskeletal Diseases/Spine, University of Basel, Basel, Switzerland

    Stefan Schaeren & Bernhard Jeanneret

  4. Center for Spine Surgery and Neurotraumatology, BG-Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany

    Stavros I. Stavridis & Klaus John Schnake

Authors
  1. Stavros I. Stavridis
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  2. Petra Bücking
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  3. Stefan Schaeren
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  4. Bernhard Jeanneret
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  5. Klaus John Schnake
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Correspondence to Klaus John Schnake.

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Stavridis, S.I., Bücking, P., Schaeren, S. et al. Implant removal after posterior stabilization of the thoraco-lumbar spine. Arch Orthop Trauma Surg 130, 119–123 (2010). https://doi.org/10.1007/s00402-009-0962-1

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  • DOI: https://doi.org/10.1007/s00402-009-0962-1

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