Complications associated with the technique of pedicle screw fixation in thoracic and lumbar spine in 100 consecutive cases

ABSTRACT

This was a prospective study done in the emergency centre of Mansoura university hospital. Ben ha university hospital and Zagazig university hospital where we reviewed the complications associated with the technique of pedicle screw fixation in 100 patients with spinal instabilities for different reasons where 520 pedicle screws were inserted by five different surgeons but with the same technique. The most common intraoperative problem was unrecognized screw misplacement [8.5% of the total screws inserted]. Fracturing of the pedicle and iatrogenic cerebrospinal fluid leak occurred in 3 patients [3%]. Neurological deficits occurred in 7% of the patients and in 4% reoperations were required. Infection occurred in 8 patients [8%] and required reoperations in 5%. Screw breakage occurred in 1.3% of the total screws inserted with no significant disabilities recorded. A careful analysis of our 100 patients shows that pedicle screw placement may be associated with significant intraoperative and postoperative complications. The intraoperative complications and inadequacies can be kept to a minimum, if attention is paid to careful planning, knowledge of anatomy and careful attention to the technique and details. Also familiarity with the technique and experience results in further diminution of morbidity as shown in our study of the first and second 50 consecutive patients