New-Onset Radiculopathy on Unaffected Side Post Spine Surgery-S1 Screw Irritating L5 Nerve Root: A Case Report

Acute onset of neuropathic pain after lumbosacral fusion spine surgery can be due to multiple causes including a laterally directed bicortical S1 pedicle screw. We here are reporting a case where a laterally directed S1 pedicle screw irritating the L5 nerve root and producing a postoperative acute onset radicular pain on an unaffected side. After the failure of 1-month conservative treatment, the patient was operated and s1 screw was revised. While placing bicortical sacral screw, surgeons should stick to safe window described on cadaveric studies and MRI is a non-invasive and reliable method to identify and nerve root irritation by bicortical sacral screws.