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The current clinical gold standard to assess the condition and detect loosening of pedicle screw implants is radiation-emitting medical imaging. However, solely based on medical imaging, clinicians are not able to reliably identify loose implants in a substantial amount of cases. To complement medical imaging for pedicle screw loosening detection, we propose a new methodology and paradigm for the radiation-free, non-destructive, and easy-to-integrate loosening detection based on vibroacoustic sensing. For the detection of a loose implant, we excite the vertebra of interest with a sine sweep vibration at the spinous process and use a custom highly sensitive piezo vibration sensor attached directly at the screw head to capture the propagated vibration characteristics which are analyzed using a detection pipeline based on spectrogram features and a SE-ResNet-18. To validate the proposed approach, we propose a novel, biomechanically validated simulation technique for pedicle screw loosening, conduct experiments using four human cadaveric lumbar spine specimens, and evaluate our algorithm in a cross-validation experiment. The proposed method reaches a sensitivity of 91.50 ± 6.58 % and a specificity of 91.10 ± 2.27 % for pedicle screw loosening detection., Competing Interests: Declarations Ethics approval An ethical approval for all ex-vivo experiments (Kantonale Ethikkommission Zurich, protocol number: 2020-01913) as well as informed consent from all subjects involved in this study and/or their legal guardians has been obtained. All experiments presented within this paper were carried out in accordance with relevant guidelines and regulations. Conflict of interest The authors declare no competing interests., (© 2024. The Author(s).)