Method for removing orthopaedic hardware

Abstract

A method for gaining access to and removing mechanical fasteners such as pedicle screws. A small arthroscopic incision is made over the location of the fastener. A guide wire is then placed into the incision and attached to the fastener. A series of progressively enlarging dilator tubes are slipped into the incision to progressively enlarge its diameter. A screw extractor tube is placed into the incision, over the largest dilator tube. The screw extractor tube is advanced until its lower extreme surrounds the head of the fastener. The dilator tubes are then removed. At this point, the screw extractor tube holds open the incision and provides access to the fastener through its hollow interior. A specially designed extractor tool is inserted into the screw extractor tube. An arthroscope is preferably also inserted through the screw extractor tube so that the surgeon can visualize the process. Jaws on the end of the extractor tool are clamped to the fastener's head. The extractor tool is then rotated to back out the fastener. Once the fastener is freed from its installed position, the extractor tool withdraws it through the screw extractor tube. Other conventional processes—such as debridement—may then be performed through the screw extractor tube. Finally, the surgeon withdraws the screw extractor tube and closes the small incision.