COMPLICATIONS ASSOCIATED WITH THE TECHNIQUE OF PEDICLE SCREW FIXATION- A SELECTED SURVEY OF ABS MEMBERS

A limited survey analysis of 617 surgical cases in which pedicle screw implants were used was undertaken to ascertain the incidence and vari ety of associated complications. The different implant systems used in cluded variable spinal plating (n = 249), Edwards (n = 143), and AO fi xateur interne (n = 101). The most common intraoperative problem was u nrecognized screw misplacement (5.2%). Fracturing of the pedicle durin g screw insertion and iatrogenic cerebrospinal fluid leak occurred in 4.2% of cases. The postoperative deep infection rate was 4.2%. Transie nt neuropraxia occurred in 2.4% of cases, and permanent nerve root inj ury occurred in 2.3% of cases. Previously unreported injury to nerve r oots occurred late in the postoperative course in three cases. Screw b reakage occurred in 2.9% of cases. All other complications had an inci dence of less than 2%. The authors conclude that pedicle screw placeme nt may be associated with significant intraoperative and postoperative complications. This information is of value to surgeons using pedicle implant systems as well as to their patients. Repeat surgery is assoc iated with greater numbers of complications.