Revision of Steffee plate instrumentation – Challenges and technical tips

There is a vast change in type of pedicle screws leading to ease of fixation and implantation. We present two cases of traumatic spine surgery, 13 and 15 years ago, that underwent thoracolumbar and lumbarsacral fusion with Steffee plates. They presented with adjacent level complications and we here report the challenges with the removal of the Steffee system. When removing the Steffee system one has to include a Steffee plate removal set, wide exposure of all the ends of the plate, gentle chiselling of the overgrown bone off the edges, slow removal of bolts with plate acting as anti- torque and gentle unscrewing to prevent inadvertent breaches.