Abstract
The complications of 648 consecutively inserted Universal AO pedicle screws (140 in the thoracic spine and 508 in the lumbar spine) performed by one surgical team to treat 91 patients with spinal problems, were reviewed. The spinal pathology consisted of: scoliosis (34 patients), degenerative lower lumbar spinal disease (25 patients), neoplastic spinal disease (11 patients), thoracic kyphosis (8 patients), spinal fractures (7 patients), lumbo-sacral spondylolisthesis (3 patients), and osteomyelitis (3 patients). Intraoperative complications were: screw misplacement (n = 3), nerve root impingement (n = 1), cerebrospinal fluid leak (n = 2) and pedicle fracture (n = 2). Postoperative complications were; deep wound infection (n = 4), screw loosening (n = 2) and rod-screw disconnection (n = 1). The conclusion was that pedicle screw fixation has an acceptable complication rate and neurological injury during this procedure is unlikely.
Key words: Spinal instrumentation, Pedicle screw
Full Text
The Full Text of this article is available as a PDF (274.9 KB).
References
- 1.Blumenthal S, Gill K. Complications of the Wiltse pedicle screw fixation system. Spine. 1993;18:1867–1871. doi: 10.1097/00007632-199310000-00024. [DOI] [PubMed] [Google Scholar]
- 2.Frymoyer J (1991) The adult spine, principles and practice, vol 2. Raven Press, p 2002
- 3.Louis R. Fusion of the lumbar and sacral spine by internal fixation with screw plate. Clin Orthop. 1986;203:1933. [PubMed] [Google Scholar]
- 4.Matsuzaki H, Tokuhashi Y, Matsumoto E, et al. Problems and solutions of pedicle screw plate fixation of the lumbar spine. Spine. 1990;15:1159–1163. doi: 10.1097/00007632-199011010-00014. [DOI] [PubMed] [Google Scholar]
- 5.McGuire RA, Amundson GM. The use of internal fixation in spondylolisthesis. Spine. 1993;18:1662–1672. doi: 10.1097/00007632-199309000-00015. [DOI] [PubMed] [Google Scholar]
- 6.Mulholland RC. Pedicle screw fixation in the spine (editorial) J Bone Joint Surg Br. 1994;76:517–519. [PubMed] [Google Scholar]
- 7.Ohlin A, Karlsson M, Duppe H, et al. Complications after transpedicular stabilisation of the spine. Spine. 1994;19:2774–2779. doi: 10.1097/00007632-199412150-00007. [DOI] [PubMed] [Google Scholar]
- 8.Roy-Camille R, et al. Internal fixation of lumbar spine with pedicle screw plating. Clin Orthop. 1986;203:7–17. [PubMed] [Google Scholar]
- 9.Sanford HD, Myers LM. Complications of lumbar spinal fusion with transpedicular instrumentation. Spine. 1992;17:183–189. doi: 10.1097/00007632-199206001-00021. [DOI] [PubMed] [Google Scholar]
- 10.Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine. 1990;15:11–14. doi: 10.1097/00007632-199001000-00004. [DOI] [PubMed] [Google Scholar]
- 11.Weinstein SL (1994) The paediatric spine, principles and practice, vol 2. Raven Press, p 1723
- 12.Weinstein JN, Zeilke K, Bohm H. Anatomic and technical consideration of pedicle screw fixation. Clin Orthop. 1993;284:34–36. [PubMed] [Google Scholar]
- 13.West JL, Oglivie JW, Bradford DW. Complications of the variable plate pedicle screw fixation. Spine. 1991;16:576–579. doi: 10.1097/00007632-199105000-00016. [DOI] [PubMed] [Google Scholar]
- 14.Zendrick M. Analysis of the morphometric characteristics of the thoracic and lumbar pedicle. Spine. 1987;12:160–166. doi: 10.1097/00007632-198703000-00012. [DOI] [PubMed] [Google Scholar]