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08-NOVEMBER-2017 RAED MUSLEH AL-RASH 29 YEARS
FRACTURED TRANSPEDICULAR FIXATING DEVICE AT L2,3,4 WITH LBP.
The patient came to the clinic 05-November-2017
complaining of LBP after feeling crack in the
spine yesterday. The patient underwent
unnecessary fixation of L2-3-4 in November-2016
for wedging of L3. The patient was consulted by
me at that time, before surgery and he was
advised to keep in conservative treatment.
On examination; the patient is limping with
exaggerated scoliotic stance. SLRS was 30 degrees in
the left with pain. There is weak
dorsiflexion left foot 4/5 with absent AJ in the
The patient was sent for investigation. MRI lumbar spine showed bulge L4-5
with mild wedging of L3. Dynamic studies showed
fracture of the left L4 screw with rod slightly
extruded upward and the nut of the right screw
slipped up. The transpedicular screws at L2 are
pushed upward both sides.
Exposure of the construct and
the screws and the rods were removed.
The tip of the screw in the left side of L4 body
was left in place. Routine closure of the
Smooth postoperative recovery. The power of
left foot became normal.
He was sent to the ward.
The patient underwent unnecessary
fixation of the spine. Such devices have their complications
and this case is a demonstration.
The dorsiflexion weakness of the left
foot was due to pain before surgery.