Abstract

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.

Keywords

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