Kocher forceps assisted pedicle screw insertion as an aid to the trainee spinal surgeon.

Abstract

Our technique uses instruments available in all arthroplasty sets. Once adequate exposure of the entire cup is achieved, a Sterling punch is used to direct a forceful blow on the metallic shell only (Fig 1). Such action resonates the bearing and deforms the taper, causing loosening of the ceramic. The force must be applied to the metal shell only, and not the bearing, to avoid ceramic shattering. The tip from a pulse lavage gun, with integrated vacuum suction, is then used to create a seal around the periphery of the bearing. The suction creates a vacuum strong enough to pull the bearing out of the shell readily (Fig 2). We use this technique routinely when removing hard bearings from a securely fixed shell.