A Rapid and Safe Minimally Invasive Procedure for Percutaneous Pedicle Screw Removal: A Case-Control Study and Technical Description

Abstract

Purpose

Percutaneous pedicle screw fixation is a common minimally invasive treatment for traumatic thoracolumbar and lumbar fractures; however, research on hardware removal after successful healing is limited. We aimed to introduce a rapid, safe, minimally invasive, and cost-effective method for percutaneous pedicle screw removal.

Patients and Methods

We conducted a retrospective analysis of demographic (age, sex, body mass index, alcohol use, and current smoking), clinical (hypertension and diabetes mellitus), surgical (affected levels, number of screws, time of surgery, and blood loss), and treatment cost characteristics of 92 patients who had undergone percutaneous pedicle screw removal between May 2016 and February 2023. The first 57 patients underwent the conventional method, and the remaining 35 underwent the modified method. Independent-sample t-tests and chi-square tests were used to compare continuous and categorical variables, respectively, between the two groups.

Results

No significant differences were observed in the demographic parameters, complications, or affected levels between the groups. However, the average surgical time (P=0.000) was significantly shorter, and the average blood loss volume (P=0.002) and total cost (P=0.000) were significantly lower in the modified group than in the conventional group.

Conclusion

Compared with the conventional method, our modified method can shorten the surgical time, reduce blood loss, and reduce the total cost of treatment. It is a quick and safe minimally invasive method that does not require additional surgical instruments and is suitable for implementation in primary hospitals.

Keywords:

• bone screw
• device
• Kirschner wire
• surgery
• control

Data Sharing Statement

The additional unpublished data from the study can be obtained from the corresponding author.

Ethics Approval and Informed Consent

This study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the ethics committee of Yantaishan Hospital (approval no. 2023105). Written informed consent was obtained from each patient, or their authorized signatory, whose images or clinical data were used.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.