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Spine and Back Health

Screw breakage

08/12/2008

Question:

My boyfriend had neck surgery 6 years ago and now has two screws holding C1 and C2 together. He has been having a lot of pain and went to a doctor to have x-rays done thinking he may have a new problem, but the x-rays show that both of the screws are broken in half. What could have caused this and how common is it?

Answer:

Hello, thank you for your question. The most common cause of screw breakage after this type of surgery is a failed fusion, meaning the bones never successfully knitted together. The screws are intended to be temporary stabilizers of the bones, until the fusion can occur, which usually takes about 9-10 months. At that point, the screws become unnecessary, but are usually not removed because it would take another surgery to remove them. However, if the bone never fuses, the constant motions of the head put stress on the screws and can eventually break them. Your boyfriend should be evaluated by a qualified spine surgeon to see whether he ever fused. Usually a CT scan (CAT scan) is the best way to determine fusion status. Good luck

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University