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

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.

The Incidence of Screw Failure in Fenestrated Polyaxial Pedicle Screws vs. Conventional Pedicle Screws in the Treatment of Adolescent Idiopathic Scoliosis (AIS)

“…To perform this surgery, the spinal implant must withstand compressive, torsional, and bending loads. For this reason, one of the most common complications in spinal fusion surgeries is implant failure, especially for multi-level fusion [ 4 ]. The success of fusion surgery relies heavily on the durability and stability of the spinal implant system, which must withstand various loads and stresses post-operatively.…”