Format

Send to

Choose Destination
Orthop Traumatol Surg Res. 2018 May;104(3):421-423. doi: 10.1016/j.otsr.2017.12.008. Epub 2018 Feb 7.

Iatrogenic peritonitis following an incident during ablation of a pedicle screw.

Author information

1
Service d'orthopédie, traumatologie et chirurgie reconstructrice, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
2
Service de chirurgie minimale invasive, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
3
Service de réanimation polyvalente et surveillance continue, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
4
Service de réanimation polyvalente et surveillance continue, hôpital Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Inserm U999, centre chirurgical Marie-Lannelongue, université Paris-Sud, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: benjamin.sztrymf@abc.aphp.fr.

Abstract

Immediate complications can arise due to faulty implantation of material during fusion procedures, but none have been reported in connection with ablation of material in the spine. We report a case of intraperitoneal migration of a pedicle screw during attempted removal. It crossed the psoas muscle and perforated a small-intestine loop, triggering hemorrhagic shock and peritonitis by perforation. We analyze the causes and mechanisms underlying this exceptional case of migration, with a view to sharing preventive measures. Initial extra-pedicular screw positioning and the pressure exerted to remove it were responsible for this serious incident.

KEYWORDS:

Material ablation; Pedicle breakage; Pedicle screw; Peritonitis

PMID:
29355744
DOI:
10.1016/j.otsr.2017.12.008

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center