SPINAL FIXATION .3. COMPLICATIONS OF SPINAL INSTRUMENTATION

Spinal fixation devices can be used to form a rigid construct with the spine to replace bone, restore alignment, maintain position, and prev ent motion in the treatment of fractures, degenerative disease, neopla sm, and congenital deformities. Because most spinal constructs will ev entually fail if bone fusion does not occur, bone graft material is of ten used along with the implant to promote fusion. Conventional radiog raphs obtained in two projections, remain the mainstay of implant eval uation, demonstrating the position of the spinal elements, hardware, g raft material, and evidence of complication. Possible complications co nnected with use of fixation devices include intraoperative soft-tissu e injuries, postoperative hematomas, and infection. The components (th rough incorrect use, malpositioning at surgery, and later dislodgment or fracture) may also contribute to complications such as instability; failure of fusion; or pain, with possible resultant neurologic damage . Bone graft material can migrate or hypertrophy, resulting in impinge ment on the spinal canal or neural foramen. Radiologists should be fam iliar with the various spinal fixation devices and techniques to bette r identify evolving complications.