A revision surgery occurred on (b)(6) 2017 as a result of the proximal junctional failure with proximal screw pull out.A second revision surgery occurred (b)(6) 2017 as a result of the migration of a screw.The loose hardware was removed with an extension of fusion to t8 with proximal construct regrafting and thoracic decompression.No implants were returned for analysis and the patient was discharged with stable appearance to construct, and neurologically intact.Review of labeling: postoperative warnings: surgeons should advise patients regarding the risks of surgery and the importance of post-operative compliance.The patient should be advised to limit and restrict physical activities, especially lifting and twisting motions and any type of sport participation.The patient should be advised that implants may bend, break or loosen despite restriction in activity.The patient should be advised to avoid mechanical vibrations that may loosen the device.The patient should be advised not to smoke or consume alcohol during recovery.Possible adverse events: like other spinal system implants, the following adverse events are possible.This list is not exhaustive: delayed union or nonunion (pseudarthrosis).Bending, disassembly or fracture of implant and components.Loosening of spinal fixation implants may occur due to inadequate initial fixation, latent infection, and/or premature loading, possibly resulting in bone erosion, migration or pain.Pain, discomfort, or abnormal sensations due to the presence of the device.Pressure on skin where inadequate tissue coverage exists over the implant, with potential extrusion through the skin.Dural leak requiring surgical repair.Cessation of growth of the fused portion of the spine.Subsidence of the implant into adjacent bone.Loss of proper spinal curvature, correction, height and/or reduction.Increased biomechanical stress on adjacent levels.Improper surgical placement of the implant causing stress shielding of the graft or fusion mass.Intraoperative fissure, fracture, or perforation of the spine.Postoperative fracture due to trauma, defects, or poor bone stock.Serious complications associated with any surgery may occur.These include, but are not limited to: wound complications, infection, genitourinary disorders, gastrointestinal disorders, vascular disorders, including thrombus; bronchopulmonary disorders, including emboli; bursitis, hemorrhage, myocardial infarction, paralysis or death.
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The patient underwent spinal fixation surgery on (b)(6) 2017 which consisted of polyaxial screws, axial rod to rod connectors, locking caps, and rods from the coral spinal system, levels t10-pelvis.On (b)(6) 2020, seaspine was made aware of a revision surgery that occurred on (b)(6) 2017 as a result of postoperative proximal junctional failure with a screw migration at previously fused construct level t9-t10.A second revision occurred in sep 2017 to remove loose t10 hardware with extension of fusion to t8 with proximal construct regrafting and thoracic decompression.
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