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Thread: Broken sacral fixation screw....what happens next?

  1. #1
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    Broken sacral fixation screw....what happens next?

    I am about 2 1/3 years out from my initial surgery when I had a T3 to Sacrum fusion with pelvic fixation. A recent xrays shows a broken left screw in my pelvis. The break does not appear to be at a stress point but within the pelvis. Xrays 6 weeks before this one did not show any problem.

    Has anyone had a broken screw in the pelvis?

    What is usually done about the broken screw (if anything)?

    Why would a screw break at this point after my initial surgery?

    About 2 weeks ago, I suddenly started having a very tight sensation, a strong, dull pain over my sacrum. The discomfort increases the more that I walk.

    Help!

    Susan....falling apart

    Trying to post an xray....
    Attached Images Attached Images
    Last edited by susancook; 07-11-2015 at 11:00 PM.
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  2. #2
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    reno,nevada
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    Susan, I believe there have been a few “broken anchor” posters here in the past but I cant remember who.

    The one thing I have always wondered was why they have different diameters of screws. If a screw is removed for some reason, its nice to have the option to go larger.

    6mm dia seems to be the norm for pedicle, I have 8mm pelvic anchors. The larger size was selected due to increased stresses.

    In general, metal does and can fatigue in time.....it is a problem all across the gamut....I see this all the time in many applications. People think that metals are impervious to all sorts of things, and in reality they are not. Brass is so soft, you can actually put bite marks into it with your teeth. Tastes brassy, he he, but you get the idea.

    Too hard a metal, and it will crack.

    I wonder what effect the wheelchair has had on this? and if Dr H will replace it or pull it out?

    I know what that ache feels like, its such a drag......the hot water helped quite a bit.

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    Oh Susan not another problem. I wonder if it can be left or just taken out ?
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  4. #4
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    Southern CA
    Posts
    2,224
    I had a broken screw. Dr Bederman replaced it.
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  5. #5
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    Quote Originally Posted by susancook View Post
    I am about 2 1/3 years out from my initial surgery when I had a T3 to Sacrum fusion with pelvic fixation. A recent xrays shows a broken left screw in my pelvis. The break does not appear to be at a stress point but within the pelvis. Xrays 6 weeks before this one did not show any problem.

    Has anyone had a broken screw in the pelvis?

    What is usually done about the broken screw (if anything)?

    Why would a screw break at this point after my initial surgery?

    About 2 weeks ago, I suddenly started having a very tight sensation, a strong, dull pain over my sacrum. The discomfort increases the more that I walk.

    Help!

    Susan....falling apart

    Trying to post an xray....
    Hi Susan...

    If your lumbar fusion is solid (and it probably is), they probably don't need to do anything about the pelvic screw.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  6. #6
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    Quote Originally Posted by LindaRacine View Post
    Hi Susan...

    If your lumbar fusion is solid (and it probably is), they probably don't need to do anything about the pelvic screw.
    Why would the screw break at a non-stress point?.....especially if the fusion is solid [which it appeared to be at my surgery on 3/20/2015].

    Susan

    Thanks everyone for your kind words of support. I will not only get through this....I will thrive!
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  7. #7
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    reno,nevada
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    Quote Originally Posted by susancook View Post
    Why would the screw break at a non-stress point?.....
    If the hole is drilled crooked, the screw is under constant stress.....even without being attached to the any other hardware.

    Drilling straight holes is not an easy thing......Drills also wander easily....

    Ed
    Last edited by titaniumed; 07-13-2015 at 01:30 AM.
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  8. #8
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    Quote Originally Posted by susancook View Post
    Why would the screw break at a non-stress point?.....especially if the fusion is solid [which it appeared to be at my surgery on 3/20/2015].

    Susan

    Thanks everyone for your kind words of support. I will not only get through this....I will thrive!
    I'd have to see an xray to even try to understand what they mean.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  9. #9
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    Sunshine Coast, Queensland, Australia
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    Oh no Susan. I'm so sorry to hear this latest news. I won't say set-back, because hopefully, it won't be.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  10. #10
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    Quote Originally Posted by LindaRacine View Post
    I'd have to see an xray to even try to understand what they mean.
    Linda: I hope that you can view the broken screw above. I just had a CT of the pelvis and will see the results this week.
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  11. #11
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    Did Dr. Hart confirm that the screw is broken? Note that the other screw (on the left) looks somewhat the same. I was wondering if it's something like this:

    http://www.zimmer.com/content/dam/zi...tem-hero-2.png
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  12. #12
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    By the way, if it is broken, it's placement doesn't surprise me. It's hard to tell without a lateral, but I think the area of concern is right over the SI joint, which is very typical.

    And, even if it is broken, if Dr. Hart feels that the fusions above are going well, I'm guessing he won't do anything about the screw unless it's painful. We see broken iliac screws pretty commonly. Remember there's no fusion, so it's no surprise that some of these screws break after awhile.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  13. #13
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    Linda: "It's not over...till"
    Dr. Hart has not confirmed anything. I suppose that he is waiting for the results of the CT of the pelvis that I had last week before he lets me know what he thinks.
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  14. #14
    Join Date
    Dec 2012
    Posts
    30
    Well said, thank you. These infections are scary. Yes, please let us know what the surgeon says.

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