COMPLICATIONS AFTER TRANSPEDICULAR STABILIZATION OF THE SPINE - A SURVIVORSHIP ANALYSIS OF 163 CASES

Objectives. The authors studied complications of transpedicular stabil ization methods. Summary of Background Data. One hundred and sixty-thr ee consecutive transpedicular stabilization procedures were performed between January 1987 and December 1991. The indications for stabilizat ion were trauma (33 cases), metastatic spinal disorder (30 cases), spi nal stenosis (33 cases), spondylolisthesis (27 cases), ankylosing spon dylitis (6 cases), low back pain (22 cases), and miscellaneous (12 cas es). Methods. Patients records and the entire series of radiographs fo r each case were scrutinized by independent observers. All per- and po stoperative complications, including implant loosening and fatigue, we re recorded. Clinical and radiographic survivorship analyses of the im plants were performed. Results. Early complications were unusual and n one were associated with permanent morbidity. The probability of not h aving the implant removed in the first postoperative year was 85%. The re was a 40% risk of radiographic failure, defined as loosening or imp lant fatigue, at 6 months. The-outcome was more favorable in cases in which anterior vertebral interbody fusion was also performed. Conclusi ons. Transpedicular fixation is a safe procedure with a low incidence of serious per- and early postoperative complications. The mechanical durability of transpedicular fixators used alone is a cause for concer n.