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Posterior spinal implant failure and its clinical significance: analysis of two cases and literature review

Journal of Neurology & Stroke
Jose Francisco Sanchez-Sanchez, Ricardo Erik Robles-Ortíz, Alejandro Fabian Rodriguez Messina, Magdiel Adan Cruz-Guzmán, Jose Miguel Martinez-Betanzos, Roberto Andres Acevedo-Galindo, Maria Fernanda Lopez Carrizosa, Ali Gomez-Gonzalez 


Background: The goal of spine arthrodesis is vertebral fusion and stabilization, however there are multiple factors which don’t allow it; among the most known are implant failure and pseudarthrosis. The question is, should a revision surgery must be performed in all implant failures? Case description: We present 2 cases of screw fatigue or failure which were treated differently based on the symptoms of the patients, even when they had clear radiologic images of implant failure. Conclusion: The set of signs and symptoms are the pillar for the decision in the definitive treatment, even though the literature mentions bone-implant fusions in less than a year, instrumentation does not always fulfill its objective due to surgical and non-surgical factors; however, we must individualize each case with the aim of maintaining spinal stabilization, preserving neurological function and relieve pain.


implant failure, broken screw, fatigue screw, spinal fusion. spinal instrumentation, pseudoarthrosis