Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery

Background Data: Pedicle screw instrumentation of the thoracolumbar and lumbosacral spine is a well-known technique used to achieve rigid fixation for a wide variety of spinal disorders. However, it is technically demanding and may be associated with potential operative risks and complications. Stu...

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Autores principales:	Ahmed Elsawaf, Mohammed Hasanein, Salem Faisal
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	Thoracolumbar lumbosacral Instrumentation complications Pedicle screw fixation Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/df0af01a4be24a8f97183e98a5ea3361
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spelling	oai:doaj.org-article:df0af01a4be24a8f97183e98a5ea33612021-12-02T07:50:52ZPedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine SurgeryDOI:10.21608/ESJ.2017.55212314-89502314-8969https://doaj.org/article/df0af01a4be24a8f97183e98a5ea33612017-01-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_5521.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Pedicle screw instrumentation of the thoracolumbar and lumbosacral spine is a well-known technique used to achieve rigid fixation for a wide variety of spinal disorders. However, it is technically demanding and may be associated with potential operative risks and complications. Study Design: A retrospective clinical case study. Purpose: To determine the incidence of complications related to pedicle screw fixation of thoracolumbar and lumbosacral spine, and if it affects the final decision of the surgeons. Patients and Methods: The reported complications in 108 transpedicular thoracolumbar and lumbosacral fixation procedures were analyzed. All medical files, operative notes, and radiographs were examined. Results: Varied complications were observed in 35.2% of patients during and after surgery. General complications were found in 13.8%, most were trivial. Infection rate was 4.6%, all cured with antibiotics except one patient who required screws removal. Neurological complications were noted in 2.7% of patients. Transient root paresis developed in 1 patient due to pedicle wall perforation. Radicular pain was noted in one patient secondary to irritation from misplaced screw. Dural tears were reported in 0.9% of our patients during screws insertion. None of patients developed permanent deficit. Device-related complications occurred in 18.5% of patients, 55% of them occurred at thoracolumbar junction. Screw false passage was seen intra-operatively in 4.6%, pedicle fracture in 0.9%. Misplaced screw was reported in 5.5% and screw breakage in 3.7% of patients. Screw breakage occurred mainly in multi-level procedures which did not involve anterior column restoration (P<0.001). Conclusion: Pedicle screws instrumentation is associated with significant complication rate. However, most complications are trivial and can be avoided through applying careful operative techniques and awareness of spinal anatomy. (2016ESJ118)Ahmed Elsawaf Mohammed HasaneinSalem FaisalEgyptian Spine AssociationarticleThoracolumbarlumbosacralInstrumentationcomplicationsPedicle screw fixationNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 21, Iss 1, Pp 14-23 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Thoracolumbar lumbosacral Instrumentation complications Pedicle screw fixation Neurology. Diseases of the nervous system RC346-429
spellingShingle	Thoracolumbar lumbosacral Instrumentation complications Pedicle screw fixation Neurology. Diseases of the nervous system RC346-429 Ahmed Elsawaf Mohammed Hasanein Salem Faisal Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
description	Background Data: Pedicle screw instrumentation of the thoracolumbar and lumbosacral spine is a well-known technique used to achieve rigid fixation for a wide variety of spinal disorders. However, it is technically demanding and may be associated with potential operative risks and complications. Study Design: A retrospective clinical case study. Purpose: To determine the incidence of complications related to pedicle screw fixation of thoracolumbar and lumbosacral spine, and if it affects the final decision of the surgeons. Patients and Methods: The reported complications in 108 transpedicular thoracolumbar and lumbosacral fixation procedures were analyzed. All medical files, operative notes, and radiographs were examined. Results: Varied complications were observed in 35.2% of patients during and after surgery. General complications were found in 13.8%, most were trivial. Infection rate was 4.6%, all cured with antibiotics except one patient who required screws removal. Neurological complications were noted in 2.7% of patients. Transient root paresis developed in 1 patient due to pedicle wall perforation. Radicular pain was noted in one patient secondary to irritation from misplaced screw. Dural tears were reported in 0.9% of our patients during screws insertion. None of patients developed permanent deficit. Device-related complications occurred in 18.5% of patients, 55% of them occurred at thoracolumbar junction. Screw false passage was seen intra-operatively in 4.6%, pedicle fracture in 0.9%. Misplaced screw was reported in 5.5% and screw breakage in 3.7% of patients. Screw breakage occurred mainly in multi-level procedures which did not involve anterior column restoration (P<0.001). Conclusion: Pedicle screws instrumentation is associated with significant complication rate. However, most complications are trivial and can be avoided through applying careful operative techniques and awareness of spinal anatomy. (2016ESJ118)
format	article
author	Ahmed Elsawaf Mohammed Hasanein Salem Faisal
author_facet	Ahmed Elsawaf Mohammed Hasanein Salem Faisal
author_sort	Ahmed Elsawaf
title	Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
title_short	Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
title_full	Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
title_fullStr	Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
title_full_unstemmed	Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery
title_sort	pedicle screw-related complications in thoracolumbar and lumbosacral spine surgery
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/df0af01a4be24a8f97183e98a5ea3361
work_keys_str_mv	AT ahmedelsawaf pediclescrewrelatedcomplicationsinthoracolumbarandlumbosacralspinesurgery AT mohammedhasanein pediclescrewrelatedcomplicationsinthoracolumbarandlumbosacralspinesurgery AT salemfaisal pediclescrewrelatedcomplicationsinthoracolumbarandlumbosacralspinesurgery
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Pedicle Screw-Related Complications in Thoracolumbar and Lumbosacral Spine Surgery

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