Surgical Considerations of Entire Lumbar Spine Hardware Removal via a Minimally Invasive Approach

A retrospective analysis of 13 patients who underwent endoscopic hardware removal to resolve residual foraminal stenosis issues was performed to determine the feasibility and validity of utilizing endoscopic techniques to entirely remove spinal hardware. Tubular retractors were utilized for the procedure with a diameter of 15 to 18 mm. Surgical times ranged from 58 to 268 minutes, with the largest time delay being the need to cut the crossbars in vivo due to stripped screws, bony overgrowth, or bent hardware. Entire hardware systems can be removed via an endoscopic approach. Blood loss averaged around 90 cc but surgical times were over an hour for most procedures. Endoscopic removal of entire hardware systems can be accomplished but it offers little advantage over conventional hardware removal. The main advantages include reduced trauma and the ability of the surgery to be performed on an outpatient basis. (Journal of Surgical Orthopaedic Advances 17(2):82–84, 2008)