A patient underwent a 2-level lumbar fusion from l4 - s1 on (b)(6) 2019.During the initial procedure the surgeon had difficulty starting two g828 lock screws, both on the same side of the construct.The surgeon was using low-top tilock screws but, due to the patient anatomy, the rod did not seat well within the screw tulips.The surgeon tried to force the rod into the tulips then began threading the lock screws but had difficulty starting the thread for both screws.He tried backing the lock screws out and restarting but he was unsure if they were cross threaded.The surgeon did use the final torque shaft to final torque the screws.On the contralateral side the rod and lock screws were applied without issue.Roughly three weeks after the initial surgery the patient fell and proactively returned to the doctor even though they were not experiencing any symptoms.A precautionary x-ray was performed which revealed that one of the rods had migrated from the screws.The rod that migrated was on the side that the doctor had difficulty seating the rod and starting the lock screws.The surgeon elected to perform a revision surgery to address the issue.During the revision surgery the surgeon inspected the hardware and stated that he had cross-threaded the lock screws.Both of the cross-threaded lock screws were removed and discarded.The surgeon felt the remaining hardware was in good shape so he reseated the rod and secured it with two new lock screws.
|