Handmade Cement Spacer Technique for Pedicle Screw Placement in Revision Spinal Surgery

Transpedicle screw instrumentation is an important procedure in spinal surgery in both primary and revision procedures. Reinsertion of transpedicle screws in revision surgery is typically difficult because of scar tissue, adhesions, and loss of anatomic landmarks. Several techniques have been developed to overcome these problems, but these methods are not satisfactory and the results are unreliable. We have developed a technique using cement spacers to occupy the pedicle screw tracts while removing the pedicle screws for patients in whom reinsertion of pedicle screws is likely in later surgical stages. The screw tracts can then be easily identified. We employed this simple and effective technique in a 66-year-old woman with promising results.