You are in:Home/Publications/Pedicle Instrumentation Failure in Thoracolumbar Fixation

Dr. ahmed.mustafa :: Publications:

Pedicle Instrumentation Failure in Thoracolumbar Fixation
Authors: *Mohamed Lotfy, **Nasser M. Sayed Ahmed, **Alaa A. Farag, *Walid Raafat **Walid A. Badawy, **Hossam Ibrahim, **Islam Abou El Fotouh, **Ahmed Saleh
Year: 2007
Keywords: Not Available
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper ahmed.mustafa_Pedicle Instrumentation Failure in Thoracolumbar Fixation.pdf
Supplementary materials Not Available

Objective: The authors reviewed factors related to the surgical techniques resulting in failure of the construct of the internal fixation of thoracolumbar fractures through transpedicular screw systems and how to be avoided. Patients and Methods: The authors reviewed 280 consecutive patients with traumatic thoracolumbar fractures who underwent spinal surgical fixation with short segment transpedicular screw instrumentation at three institutions, between January 1997 and June 2005. All patients in this series were due to high-energy trauma. Among this series, 30 patients had a construct failure attributed to surgical technique causes. Clinical evaluation of the patients was performed on admission and at post-operative period using ASIA scale. All patients were radiologically investigated by plain X-rays and computerized tomographic (CT) scan spine on admission and occasionally MRI and 3D CT scan of the spine when required. The patients were followed up as regard to clinical and radiological evidences of construct failure. Results: Thirty patients out of 280 patients with post-traumatic thoracolumbar injuries had construct failures. Main clinical presentation of construct failure was severe pain and inability to walk at post-operative period. Radiologically there was progressive spinal deformity with implant failures. The locations of the fractures in order of frequency were as follows: L-1 in 18 cases, L-2 in 7 cases, T-12 in 5 cases. The construct failure was in the form of screws malposition in 13 patients, screws breakage in 10 patients, screw/rod dislodgement in 3 patients, disengaged screw's cup in 2 patients, and broken rods in 2 patients. Conclusion: Great attention must be directed to maintain the sagittal and coronal balances of the spine over the sacrum through reconstruction of comminuted anterior vertebral column, and appropriate distraction of the construct. In spite of routine use of pedicle screws, it has not been free of complications. The majority of construct failures is not actually device failures but instead is surgical technique causes.

Google ScholarAcdemia.eduResearch GateLinkedinFacebookTwitterGoogle PlusYoutubeWordpressInstagramMendeleyZoteroEvernoteORCIDScopus