Journal de la colonne vertébrale

Pitfalls of Transpedicular Screws in Non-traumatic Lumbar Spondylolisthesis

Abstract

Haitham El-Beltagy Abd El-Kader

Background: Spinal fusion and instrumentations are performed in a wide spectrum of spinal disorders including trauma, infections, degenerative deformities and spinal tumors. The application of pedicular screws is often associated with some complications which may be related to the misuse of the device, the surgeon’s skills and/or directly related to the screws themselves.

Aim of the work: was to analyze different types of complications in 240 patients with transpedicular screw and rod fixation for non-traumatic lumbar spondylolithesis with follow up period up to three years.

Methods: This retrospective study included 240 patients (160 females and 80 males with F: M ratio 2:1) with age group between 30 to 65 years old (mean age was 47.5) who underwent transpedicular screws and rod fixation for nontraumatic lumbar spondylilthesis in Al-Menoufia University Hospitals between May 2008 and April 2011.

Results: There were 20 patients (8.3%) developed different complications among 240 patients included in the study with higher incidence in males (12 cases of 80 patients) than in females (8 cases among 160 patients).

The most frequent complications reported in our study were related to insufficient surgical skills in 7 cases (35%) that lead to malposition of screws and/or permanent root injury.

Other complications include implant related complications in 6 cases (30%), adjacent level disease in 4 cases (20%) and general complications in 3 cases (15%).

Conclusion: Pedicular screw fixation significantly improved the outcome of spinal reconstruction, but it may be associated with some potential complications which include medical complications, hardware complications and longterm changes of motion segments.