Format

Send to

Choose Destination
Asian Spine J. 2014 Jun;8(3):281-97. doi: 10.4184/asj.2014.8.3.281. Epub 2014 Jun 9.

Lumbar transpedicular implant failure: a clinical and surgical challenge and its radiological assessment.

Author information

1
Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
2
Department of Orthopedic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

STUDY DESIGN:

It is a multicenter, controlled case study review of a big scale of pedicle-screw procedures from January 2000 to June 2010. The outcomes were compared to those with no implant failure.

PURPOSE:

The purpose of this study was to review retrospectively the outcome of 100 patients with implant failure in comparison to 100 control-patients, and to study the causes of failure and its prevention.

OVERVIEW OF LITERATURE:

Transpedicular fixation is associated with risks of hardware failure, such as screw/rod breakage and/or loosening at the screw-rod interface and difficulties in the system assembly, which remain a significant clinical problem. Removal or revision of the spinal hardware is often required.

METHODS:

Two hundred patients (88 women, 112 men) were divided into 2 major groups, with 100 patients in group I (implant failure group G1) and 100 patients in group II (successful fusion, control group G2). We subdivided the study groups into two subgroups: subgroup a (single-level instrumented group) and subgroup b (multilevel instrumented group). The implant status was assessed based on intraoperative and follow-up radiographs.

RESULTS:

Implant failure in general was present in 36% in G1a, and in 64% in G1b, and types of implant failure included screw fracture (34%), rod fracture (24%), rod loosening (22%), screw loosening (16%), and failure of both rod and screw (4%). Most of the failures (90%) occurred within 6 months after surgery, with no reported cases 1 year postoperatively.

CONCLUSIONS:

We tried to address the problem and study the causes of failure, and proposed solutions for its prevention.

KEYWORDS:

Fracture fixations, prosthesis; Fusion; Loosening; Lumbar, fixation; Screw, failure

Supplemental Content

Full text links

Icon for Publishing M2Community Icon for PubMed Central
Loading ...
Support Center