Clinical outcomes and complications associated with pedicle screw fixation—augmented lumbar interbody fusion

Abstract

<jats:p content-type="fine-print"><jats:italic>Object.</jats:italic> The authors conducted a prospective study to evaluate the clinical and radiological outcomes and complications associated with uni- and bilateral transforaminal lumbar interbody fusion (TLIF) performed using carbon fiber Brantigan I/F Cages and pedicle screw fixation.</jats:p> <jats:p content-type="fine-print"><jats:italic>Methods.</jats:italic> Forty-two consecutive patients who had undergone uni- or bilateral TLIF between February 1999 and July 2000 were prospectively evaluated. Clinical outcome was graded using a modified Prolo Scale, the McGill Pain Index Scale, a follow-up questionnaire, and charts. An independent radiologist assessed radiological outcomes. All patients were followed for at least 1 year.</jats:p> <jats:p content-type="fine-print">Based on Prolo Scale scores, an excellent or good 1-year outcome was achieved in 73% of patients; 90% of patients responded that they would undergo the procedure again. At 1 year, radiographic fusion was demonstrated in 74% and was statistically related to clinical outcome (p &lt; 0.05).</jats:p> <jats:p content-type="fine-print">There were no deaths or major hardware failures. Complications requiring repeated surgery included one case of cerebrospinal fluid (CSF) leakage and one case in which the hemovac drain was retained. There were four cases involving minor wound infections, eight involving CSF leaks, and none requiring repeated surgery. On routine follow-up radiography one pedicle screw was found to be broken; the patient remained asymptomatic and fusion occurred.</jats:p> <jats:p content-type="fine-print"><jats:italic>Conclusions.</jats:italic> Unilateral and bilateral TLIF involving placement of carbon fiber cages and pedicle screw fixation are effective treatment options in patients with indications for lumbar arthrodesis. The procedures result in acceptable rates of fusion and clinical success, and a minimal incidence of morbidity when performed by an experienced surgeon.</jats:p>

Comparison of Serum CRP and Procalcitonin in Patients after Spine Surgery

“…Despite advances in prophylaxis, the incidence of deep infection after instrumented spinal surgery remains between 0.4% and 4.3% 14,16,19) and may be higher in patients undergoing fusion after spinal trauma 26) . Although infection can be a disabling complication of any surgical procedure, spinal infection can be particularly devastating due to the close proximity of the neurological structures.…”

Spine fusion cross-link causing delayed dural erosion and CSF leak: case report

“…16 Other reported complications include incidental durotomies with CSF leaks, wound infections, hematomas, and possible neural injury with deficits. However, our case remains unique in the type of instrument-related complication.…”

Comparative Study of Radiographic Disc Height Changes Using Two Different Interbody Devices for Transforaminal Lumbar Interbody Fusion

“…[2][3][4][5][6][7][8][9][10][11] Various interbody devices, such as titanium mesh cages, carbon fiber reinforcement polymer cages, threaded fusion cages, and structural iliac crests, have been used in these procedures. 6,7,[12][13][14][15] Since structural corticocancellous iliac autografts usually have waning mechanical strength when acting as interbody materials, postoperative collapse or displacement of the graft is likely to occur. 16 -18 The properties required in appropriate interbody devices are therefore vertical load-bearing capability and a stable design that will resist translational or rotational forces in all directions.…”