It was reported that on (b)(6) 2011, patient underwent an unknown surgery.On (b)(6) 2017, patient presented with pre-op diagnosis: recurrence of cervical spinal disc herniation.For which patient's fixation range was extended after fixation at levels c6/7.Reportedly, intra-op, during revision surgery, pedicle screws inserted using o-arm and navi deviated.Also, biceps reaction was only 20 % during and immediately after the surgery but it is unknown if it happened due to the screw deviation.The surgeon placed a double spine firmly on c4/5 spinous process.The procedure was performed in this order (c5 left, c4 left, c5 right and c4 right).Creating pilot holes seemed difficult and the surgeon tried it over and over.The surgeon felt something wrong because the double spine also deviated (but why the double spine deviated was unknown at that point).After pedicle screw's insertion, o-arm image revealed that three out of four screws deviated.The surgeon remembered the order of insertion and there was no problem with the c5 left screw so it was judged that pedicle screws started deviating after the c5 left screw insertion.The double spine was confirmed and it was found to be loosened at this point.The surgeon tightened the double spine firmly and images were taken by o-arm again then pedicle screws were reinserted.Surgeon considers that biceps reaction fell because of worsening foraminal stenosis when the screw was inserted, rather than because of the screws deviation.Replacement and reinsertion of screws were performed as a result of this event.There was a delay of more than 60 min in overall procedure time as a result of this event.
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