case_images: PMC10293790_01
case_images: (A,B) anterior-posterior and lateral radiographs 1 year after percutaneous pedicle screw in L1. (C) Intraoperative fluoroscopy was taken and confirmed that the screw migrated anteriorly to the vertebral body. (D) Enhanced CT scanning of the abdomen found that the tip of the right L2 screw indented the IVC and left renal vein without blood extravasation.
case_images: fsurg-10-1187801-g001.jpg
case_images: PMC10293790_01_fsurg-10-1187801-g001.jpg
case_images: F1
case_images: The implant was required to remove one year after the initial surgery without sign of hardware failure or loosening, and bone healing was achieved according to radiography (Figures 1A,B). Intraoperative fluoroscopy was taken and confirmed that the screw migrated anteriorly to the vertebral body (Figure 1C). The emergency contrast-enhanced CT and CTA revealed the L2 screw had breached the anterior cortex of the L2 vertebral body and penetrated the IVC but had not caused any extravasation of contrast. (Figure 1D).
case_images: A View of the tip of the screw (black arrow) is exposed by the dissection flap of the IVC. (B) The defect of IVC was reconstructed using an artificial graft. (C) The right L2 pedicle screw was removed in the posterior approach.
case_images: fsurg-10-1187801-g002.jpg
case_images: PMC10293790_01_fsurg-10-1187801-g002.jpg
case_images: F2
case_images: Vascular control above and below the level of injury was performed, and the screw was slowly backed out (Figure 2A). Finally, the defect of IVC was reconstructed using an artificial graft. (Figure 2B). Immediately following the abdomen incision was closed, the L2 screw was then removed from the posterior approach (Figure 2C).