Abstract
This study investigated whether pedicle screws medially misplaced into the spinal canal without neurological complications should be removed or not. A total of 86 patients with scoliosis that underwent spinal fusion using 988 pedicle screws were retrospectively reviewed after a minimum follow-up of 2 years. The inclusion criteria were: (1) patients without outstanding problems during the insertion of pedicle screws, (2) patients without neurological deficits either intraoperatively or postoperatively, and (3) patients that had all implants removed after bone union upon the request of the patient. Medial perforations were evaluated using immediate postoperative helical CT images and classified into three grades: grade 1 (0-2 mm), grade 2 (2-4 mm), and grade 3 (over 4 mm). All unexpected events were recorded at the time of removal. CT images obtained 2 years postoperatively exhibited neither loosening of screws nor pseudoarthrosis in all patients. CSF leakage from screw holes were recognized in 3 of 87 medially misplaced screws (3.4 %). There was no CSF leakage in grade 1 (35 screws), one CSF leakage (2.5 %) in grade 2 (40 screws), and two (16.7 %) in grade 3 (12 screws). No neurological abnormalities occurred either intraoperati...Continue Reading
References
Jan 1, 1990·Spine·S D Gertzbein, S E Robbins
Aug 1, 1995·The Journal of Bone and Joint Surgery. American Volume·A R VaccaroJ M Cotler
Jan 6, 1999·The Journal of Bone and Joint Surgery. American Volume·J C WangK D Riew
May 20, 1999·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·P PapinM Aebi
Mar 7, 2001·The Journal of Trauma·J B ChoiJ W Jeong
Sep 8, 2001·Spine·S I SukE R Chung
Oct 18, 2001·The Journal of Bone and Joint Surgery. British Volume·D P ReidyJ A Finkelstein
Mar 12, 2002·The Journal of Bone and Joint Surgery. American Volume·Ulf R LiljenqvistHenry F H Halm
Aug 24, 2002·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·U LiljenqvistH Halm
Jan 31, 2004·Spine·Yongjung J KimK Daniel Riew
Jul 11, 2007·Spine·Mario Di SilvestreGeorgios Bakaloudis
Apr 26, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Sait AlbayramMurat Hanci
Jul 16, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Bernd WegenerHans Roland Dürr
Jul 21, 2012·Spine·Jean-Marc Mac-ThiongLabelle Hubert