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Roma suffer Coppa Italia exit at the hands of Spezia
The Giallorossi began the game with seven changes to their starting line-up from the 0-0 draw at Napoli three days ago. Captain De Rossi and Nainggolan were rested from midfield while only Rudiger started at the back, after playing in Napoli. Salah started the game with Dzeko up front, while Iturbe replaced Iago Falque.
The home side had 68% of the possession but with little effect as Salah and company rarely threatened.
However, Roma had a goal disallowed in the first half after a beautiful passing move ended with Salah putting Dzeko clear on goal. The Bosnian striker scored with a powerful low shot but was marginally offside.
The referee below the whistle at the end of 90 minutes with a scoreline 0-0 to take the game in to extra-time.
Mohamed Salah played the full 120 minutes in only his second start after coming back from the injury, which kept him out for just under two months.
Both sides failed to score in extra time as the game went to penalties. Bosnians Pjanic and Dzeko missed the first two penalty shots for Roma to condemn their side to a 4-2 shoot-out defeat.
The Coppa Italia exit continued a run of poor form for the Giallorossi, who are without a win in their past seven games.
The side is back in action at the weekend in Seria A against Genoa at the Olimpico.