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Spine
Diagnosis
Spine Postprocedural Imaging
Hardware
Hardware Failure
Hardware Failure
Jeffrey S. Ross, MD; Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Implant or prosthesis failure

            • Definitions

              • Mechanical breakdown or malfunction of hardware
                • Pseudarthorosis, subsidence

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Other Modality Findings

                          • Imaging Recommendations

                            • Ultrasonographic Findings

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Camacho JE et al: The use of minimally invasive surgery in spine trauma: a review of concepts. J Spine Surg. 5(Suppl 1):S91-100, 2019
                                                2. Baber Z et al: Failed back surgery syndrome: current perspectives. J Pain Res. 9:979-87, 2016
                                                3. Petscavage-Thomas JM et al: Imaging current spine hardware: part 1, cervical spine and fracture fixation. AJR Am J Roentgenol. 203(2):394-405, 2014
                                                4. Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
                                                5. Cahill KS et al: Prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins in spinal fusion procedures. JAMA. 302(1):58-66, 2009
                                                6. Murtagh RD et al: Normal and abnormal imaging findings in lumbar total disk replacement: devices and complications. Radiographics. 29(1):105-18, 2009
                                                7. Stradiotti P et al: Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art. Eur Spine J. 18 Suppl 1:102-8, 2009
                                                8. Park JB et al: Timing of development of adjacent-level ossification after anterior cervical arthrodesis with plates. Spine J. 7(6):633-6, 2007
                                                9. Rutherford EE et al: Lumbar spine fusion and stabilization: hardware, techniques, and imaging appearances. Radiographics. 27(6):1737-49, 2007
                                                10. Park JB et al: Development of adjacent-level ossification in patients with an anterior cervical plate. J Bone Joint Surg Am. 87(3):558-63, 2005
                                                11. Cannada LK et al: Pseudoarthrosis of the cervical spine: a comparison of radiographic diagnostic measures. Spine (Phila Pa 1976). 28(1):46-51, 2003
                                                12. Singh SK et al: Occipitocervical reconstruction with the Ohio Medical Instruments Loop: results of a multicenter evaluation in 30 cases. J Neurosurg. 98(3 Suppl):239-46, 2003
                                                13. Bagchi K et al: Hardware complications in scoliosis surgery. Pediatr Radiol. 32(7):465-75, 2002
                                                14. Apfelbaum RI et al: Direct anterior screw fixation for recent and remote odontoid fractures. J Neurosurg. 93(2 Suppl):227-36, 2000
                                                15. Deckey JE et al: Loss of sagittal plane correction after removal of spinal implants. Spine. 25(19):2453-60, 2000
                                                16. Glassman SD et al: The durability of small-diameter rods in lumbar spinal fusion. J Spinal Disord. 13(2):165-7, 2000
                                                17. Geiger F et al: Complications of scoliosis surgery in children with myelomeningocele. Eur Spine J. 8(1):22-6, 1999
                                                18. Wetzel FT et al: Hardware failure in an unconstrained lumbar pedicle screw system. A 2-year follow-up study. Spine. 24(11):1138-43, 1999
                                                19. Lowery GL et al: The significance of hardware failure in anterior cervical plate fixation. Patients with 2- to 7-year follow-up. Spine. 15;23(2):181-6; discussion 186-7, 1998
                                                20. Masferrer R et al: Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review. J Neurosurg. 89(3):371-7, 1998
                                                21. Wellman BJ et al: Complications of posterior articular mass plate fixation of the subaxial cervical spine in 43 consecutive patients. Spine. 23(2):193-200, 1998
                                                22. Shapiro SA et al: Spinal instrumentation with a low complication rate. Surg Neurol. 48(6):566-74, 1997
                                                23. Paramore CG et al: Radiographic and clinical follow-up review of Caspar plates in 49 patients. J Neurosurg. 84(6):957-61, 1996
                                                24. Blumenthal S et al: Complications of the Wiltse Pedicle Screw Fixation System. Spine. 18(13):1867-71, 1993
                                                25. Guidera KJ et al: Cotrel-Dubousset instrumentation. Results in 52 patients. Spine. 18(4):427-31, 1993
                                                26. McLain RF et al: Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report. J Bone Joint Surg Am. 75(2):162-7, 1993
                                                27. Slone RM et al: Spinal fixation. Part 3. Complications of spinal instrumentation. Radiographics. 13(4):797-816, 1993
                                                28. Wilkinson RH et al: Radiographic evaluation of the spine after surgical correction of scoliosis. AJR Am J Roentgenol. 133(4):703-9, 1979
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Implant or prosthesis failure

                                                          • Definitions

                                                            • Mechanical breakdown or malfunction of hardware
                                                              • Pseudarthorosis, subsidence

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • Fluoroscopic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Other Modality Findings

                                                                        • Imaging Recommendations

                                                                          • Ultrasonographic Findings

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Camacho JE et al: The use of minimally invasive surgery in spine trauma: a review of concepts. J Spine Surg. 5(Suppl 1):S91-100, 2019
                                                                                              2. Baber Z et al: Failed back surgery syndrome: current perspectives. J Pain Res. 9:979-87, 2016
                                                                                              3. Petscavage-Thomas JM et al: Imaging current spine hardware: part 1, cervical spine and fracture fixation. AJR Am J Roentgenol. 203(2):394-405, 2014
                                                                                              4. Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
                                                                                              5. Cahill KS et al: Prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins in spinal fusion procedures. JAMA. 302(1):58-66, 2009
                                                                                              6. Murtagh RD et al: Normal and abnormal imaging findings in lumbar total disk replacement: devices and complications. Radiographics. 29(1):105-18, 2009
                                                                                              7. Stradiotti P et al: Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art. Eur Spine J. 18 Suppl 1:102-8, 2009
                                                                                              8. Park JB et al: Timing of development of adjacent-level ossification after anterior cervical arthrodesis with plates. Spine J. 7(6):633-6, 2007
                                                                                              9. Rutherford EE et al: Lumbar spine fusion and stabilization: hardware, techniques, and imaging appearances. Radiographics. 27(6):1737-49, 2007
                                                                                              10. Park JB et al: Development of adjacent-level ossification in patients with an anterior cervical plate. J Bone Joint Surg Am. 87(3):558-63, 2005
                                                                                              11. Cannada LK et al: Pseudoarthrosis of the cervical spine: a comparison of radiographic diagnostic measures. Spine (Phila Pa 1976). 28(1):46-51, 2003
                                                                                              12. Singh SK et al: Occipitocervical reconstruction with the Ohio Medical Instruments Loop: results of a multicenter evaluation in 30 cases. J Neurosurg. 98(3 Suppl):239-46, 2003
                                                                                              13. Bagchi K et al: Hardware complications in scoliosis surgery. Pediatr Radiol. 32(7):465-75, 2002
                                                                                              14. Apfelbaum RI et al: Direct anterior screw fixation for recent and remote odontoid fractures. J Neurosurg. 93(2 Suppl):227-36, 2000
                                                                                              15. Deckey JE et al: Loss of sagittal plane correction after removal of spinal implants. Spine. 25(19):2453-60, 2000
                                                                                              16. Glassman SD et al: The durability of small-diameter rods in lumbar spinal fusion. J Spinal Disord. 13(2):165-7, 2000
                                                                                              17. Geiger F et al: Complications of scoliosis surgery in children with myelomeningocele. Eur Spine J. 8(1):22-6, 1999
                                                                                              18. Wetzel FT et al: Hardware failure in an unconstrained lumbar pedicle screw system. A 2-year follow-up study. Spine. 24(11):1138-43, 1999
                                                                                              19. Lowery GL et al: The significance of hardware failure in anterior cervical plate fixation. Patients with 2- to 7-year follow-up. Spine. 15;23(2):181-6; discussion 186-7, 1998
                                                                                              20. Masferrer R et al: Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review. J Neurosurg. 89(3):371-7, 1998
                                                                                              21. Wellman BJ et al: Complications of posterior articular mass plate fixation of the subaxial cervical spine in 43 consecutive patients. Spine. 23(2):193-200, 1998
                                                                                              22. Shapiro SA et al: Spinal instrumentation with a low complication rate. Surg Neurol. 48(6):566-74, 1997
                                                                                              23. Paramore CG et al: Radiographic and clinical follow-up review of Caspar plates in 49 patients. J Neurosurg. 84(6):957-61, 1996
                                                                                              24. Blumenthal S et al: Complications of the Wiltse Pedicle Screw Fixation System. Spine. 18(13):1867-71, 1993
                                                                                              25. Guidera KJ et al: Cotrel-Dubousset instrumentation. Results in 52 patients. Spine. 18(4):427-31, 1993
                                                                                              26. McLain RF et al: Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report. J Bone Joint Surg Am. 75(2):162-7, 1993
                                                                                              27. Slone RM et al: Spinal fixation. Part 3. Complications of spinal instrumentation. Radiographics. 13(4):797-816, 1993
                                                                                              28. Wilkinson RH et al: Radiographic evaluation of the spine after surgical correction of scoliosis. AJR Am J Roentgenol. 133(4):703-9, 1979