CTICasesRecurrent Pneumothorax secondary to Paraspinal Pedicle Screw Impingement
Imaging findings
Chest CT demonstrates a large right pneumothorax with associated focal scarring and atelectasis in the posterior right lower lobe. Axial images and 3D reconstructions reveal paraspinal spinal fusion rods and pedicle screws, with the topmost screw clearly protruding anteriorly beyond the vertebral body, penetrating directly into the right pleural space and surrounded by pleural air.
Key takeaways
Intrathoracic protrusion or anterior migration of spinal instrumentation, such as pedicle screws, is a rare but important mechanical cause of recurrent or persistent pneumothorax. Misplaced hardware can erode the parietal pleura and cause chronic friction and laceration of the adjacent lung parenchyma, necessitating surgical hardware revision or pleurodesis.
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