Complications of lumbar spinal fusion with transpedicular instrumentation

Transpedicular screw fixation systems are coming into wide use as an adjunct to lumbar spinal fusion procedures. This 5-year series included 486 patients who underwent 533 variable screw placement procedures for discal, degenerative, and spondylolytic problems. The wound infection rate was 2.6%: 0.6...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 1992-06, Vol.17 (6), p.S184-S189
Main Authors: DAVNE, S. H, MYERS, D. L
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Bone Screws
Equipment Failure
Humans
Incidence
Lumbar Vertebrae - surgery
Medical sciences
Orthopedic surgery
Prospective Studies
Retrospective Studies
Spinal Fusion - adverse effects
Spinal Fusion - instrumentation
Spinal Nerve Roots - injuries
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical Wound Infection - epidemiology
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Summary:Transpedicular screw fixation systems are coming into wide use as an adjunct to lumbar spinal fusion procedures. This 5-year series included 486 patients who underwent 533 variable screw placement procedures for discal, degenerative, and spondylolytic problems. The wound infection rate was 2.6%: 0.6% deep, 0.9% graft, and 1.1% superficial. The neural injury rate was 1.1% overall: 0.6% related to posterior lumbar interbody fusion and 0.6% related to instrumentation. Technical problems per procedure included 8.1% difficult screw placement, 5.6% nut loosening, and 4.3% screw breakage (1.1% per screw placed). Device modifications have reduced the incidence of screw breakage and nut loosening. No device-related neural injuries occurred in the last 333 procedures. With experience, the device can be applied safely without significantly increasing the risk of neural injury or morbidity.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-199206001-00021