Pedicle screw instrumentation is a widely used technique for fixating the spine in fusion surgery. One of the complications associated with pedicle screw placement is when a screw breaches the pedicle medially and causes the patient radicular pain or numbness or weakness. Revising a breached pedicle screw in a patient who has undergone a multilevel fusion surgery often requires that the patient undergo a very invasive revision surgical procedure. Here the authors present a technical note on decompressing an S1 nerve compressed by a breached pedicle screw by performing an endoscopic surgical approach through a 1-cm incision and drilling down the threads of the pedicle screw, directly decompressing the nerve without removing the screw.
Keywords: Endoscopic spine surgery; laminectomy; minimally-invasive spine; pedicle screw; radiculopathy.