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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 Files
    Last edited by susancook; 07-11-2015, 10:00 PM.
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev 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
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

  • #2
    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 63, the new 64...
    Pre surgery curves T70,L70
    ALIF/PSA 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

    Comment


    • #3
      Oh Susan not another problem. I wonder if it can be left or just taken out ?
      T10-pelvis fusion 12/08
      C5,6,7 fusion 9/10
      T2--T10 fusion 2/11
      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
      Broken neck 9/28/2018
      Emergency surgery posterior fusion C4- T3
      Repeated 11/2018 because rods pulled apart added T2 fusion
      Removal of partial right thoracic hardware 1/2020
      Removal and replacement of C4-T10 hardware with C7 and T 1
      Osteotomy

      Comment


      • #4
        I had a broken screw. Dr Bederman replaced it.
        Melissa

        Fused from C2 - sacrum 7/2011

        April 21, 2020- another broken rod surgery

        Comment


        • #5
          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. --Twain
          ---------------------------------------------------------------------------------------------------------------------------------------------------
          Surgery 2/10/93 A/P fusion T4-L3
          Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

          Comment


          • #6
            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 Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

            2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
            2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
            2015: Rev 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
            2018: Removal L4,5 screw
            2021: Removal T1 screw & rod

            Comment


            • #7
              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, 12:30 AM.
              49 yr old male, now 63, the new 64...
              Pre surgery curves T70,L70
              ALIF/PSA 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

              Comment


              • #8
                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. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  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

                  Comment


                  • #10
                    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 Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                    2015: Rev 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
                    2018: Removal L4,5 screw
                    2021: Removal T1 screw & rod

                    Comment


                    • #11
                      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. --Twain
                      ---------------------------------------------------------------------------------------------------------------------------------------------------
                      Surgery 2/10/93 A/P fusion T4-L3
                      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                      Comment


                      • #12
                        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. --Twain
                        ---------------------------------------------------------------------------------------------------------------------------------------------------
                        Surgery 2/10/93 A/P fusion T4-L3
                        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                        Comment


                        • #13
                          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 Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                          2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                          2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                          2015: Rev 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
                          2018: Removal L4,5 screw
                          2021: Removal T1 screw & rod

                          Comment


                          • #14
                            Well said, thank you. These infections are scary. Yes, please let us know what the surgeon says.

                            Comment

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