ABSTRACT
The operative setup depends on the location of the pedicle screw. If the screw is extraosseous and near the aorta, but not in contact with the aorta, the patient can often be placed in the supine position and the screw simply removed. Most patients who undergo a removal of the pedicle screw have no major sequel; however, it is critical that patients understand the risk of the surgery, as well as the risks of leaving the screw in place. While an endovascular aortic repair offers a less invasive approach to removal of pedicle screws, thoracotomy may be preferred in some cases because it allows better visualization of the aorta. In the immediate postoperative period, patients should be evaluated to ensure that they are neurologically and vascularly intact and their status unchanged from prior to surgery. Thoracotomy allows excellent visualization and access to the aorta in the event that direct clamping for hemostasis is required.
