The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States

Eric W. Sankey, Vikram A. Mehta, Timothy Y. Wang, Tracey T. Than, C. Rory Goodwin, Isaac O. Karikari, Christopher I. Shaffrey, Muhammad M. Abd-El-Barr, Khoi D. Than

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Spine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentation. However, the medicolegal impact of misplaced screws on spine surgery has not been directly reported in the literature. The authors of the current study aimed to describe this impact in the United States, as well as to suggest a potential method for mitigating the problem. This retrospective analysis of 68 closed medicolegal cases related to misplaced screws in spine surgery showed that neurosurgeons and orthopedic spine surgeons were equally named as the defendant (n = 32 and 31, respectively), and cases were most commonly due to misplaced lumbar pedicle screws (n = 41, 60.3%). Litigation resulted in average payouts of $1,204,422 ± $753,832 between 1995 and 2019, when adjusted for inflation. The median time to case closure was 56.3 (35.2–67.2) months when ruled in favor of the plaintiff (i.e., patient) compared to 61.5 (51.4–77.2) months for defendant (surgeon) verdicts (p = 0.117).

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalNeurosurgical focus
Issue number5
StatePublished - Nov 2020


  • defendant
  • intraoperative imaging
  • lawsuit
  • medical legal
  • medicolegal
  • misplaced
  • payout
  • pedicle screw
  • plaintiff
  • spine

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States'. Together they form a unique fingerprint.

Cite this