[Complication of thoracic pedicle screw fixation in spinal deformities].

Zhong Nan Da Xue Xue Bao Yi Xue Ban

Department of Spine Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.

Published: August 2009

AI Article Synopsis

  • The study examined the causes and prevention of complications from the pedicle screw technique used to treat thoracic scoliosis in 183 patients with different scoliosis types.
  • The results showed a 72% rate of successful deformity correction and a low overall complication rate, with perioperative complications at 8.4% and follow-up complications at 3.6%.
  • The conclusion emphasized that with proper surgeon training and monitoring, complications from this technique can be effectively managed.

Article Abstract

Objective: To analyze the etiology and prevention of complications related to the pedicle screw technique in the treatment of thoracic scoliosis.

Methods: There were 183 thoracic deformity patients 110 idiopathic scoliosis, 32 adult scoliosis, 28 congenital kyphoscoliosis, 8 Marfan syndrome with scoliosis, and 6 others. All patients' Cobb angles were evaluated preoperatively, intraoperatively, and postoperatively by roentgenograms. The deformity correction rate was calculated. All radiographic evaluations were carried out in a double-blind fashion. The complication rate was analyzed perioperatively and postoperatively.

Results: The deformity correction rate was 72%, better than others treated with hook-rod system. The perioperation complication rate was 8.4% (pedicle fracture 1.5%, infection 3.8%, pneumothorax and plural effusion 1.6%, transitory neurological damage 0.5%, and over-bleeding shock 1%). The complication rate at follow-up was 3.6% (infection 0.5%, fatigue fracture 1%, loss of deformity correction 1.6%, and transitory neurological damage 0.5%). Compared with those treated with hook-rod system, the perioperation complication rate, loss of deformity correction, permanent damage, and complications related to the internal fixation were all low.

Conclusion: The complication rate of pedicle screw fixation system was low in the treatment of thoracic deformity. When surgeons are thoroughly familiar with the technique and related pathoanatomy, and with the spinal cord function wardship by SEP, complications related to the pedicle screw technique in the treatment of thoracic scoliosis will be well controlled.

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