The patient came to the clinic 28-March-2004 telling that after RTA 6 months ago got fracture  L4, for what transpedicular screws were inserted 16-November-2003 elsewhere.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 45 degrees both sides with pain. There is weak dorsi and planterflexion both feet 4/5 with weak left quadriceps muscle 4/5. The old and new requested investigations showed that the patient was essentially had stable fracture and was not in need for fixation and the inserted device was with a lot of mistakes, the upper screws in the L3-4 disc space and the lower ones inside the vertebral canal.

Considering that the construct only causing harm to the patient , the construct was exposed and there was no screw remover, for what drilling of the screws achieved the result. All the construct was removed. To avoid possible CSF leak from the screws insertion pieces of muscles were inserted to the cavities of the removed screws. Routine closure of the wound. Smooth postoperative recovery. The power of both feet normalized.

The patient came to the clinic 14-April-2004 with clean wound and SLRS still 45 degrees both sides with pain, but no sensory nor motor deficit.

The patient then came several times and the last 15-October-2006 after performing MRI and LSS X-ray confirming normal alignment of the spine . He took report for legal purposes.

This case showing over use of transpedicular screws. Strict criteria must be followed to whom this must be used. At least do not do harm to the patient.