Interbody Fusion. Is It Has a Rule in Broken Screws in Surgical Management of Lumbar Spondylolisthesis?
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 71, Issue 5
Abstract
<span>Background: </span><span>for many years, posterolateral fixation for lumbar spondylolisthesis by using pedicle screw has been the standard procedure for lumbar spondylolisthesis. For increasing fusion and anterior support, the interbody fusion, either with cage or bone, were used by many surgeons, one of the most disappointing complications of pedicle screw fixation is broken screw.<br /> </span><span>Aim: </span><span>it was to compare the number of cases with a broken screw in case of interbody fusion and control group. </span><span>Patients and Methods: </span><span>this is retrospective cohort study in six years comparing between two groups: Group I posterolateral fixation (PLF), Group II posterolateral interbody fusion (PLIF). it analyzed 26 cases of broken screw occurred in six years from 2010 to 2016 which were done in Nasser Institute by the same surgeon and same system. </span><span>Results: </span><span>twenty-six cases were reviewed, the mean age was 44.6 years, female : 6/26 (23%), male : 20/26 (77%),mean weight: 74.8 kg, site for broken screw: (L1: 4 patients </span><span>– </span><span>L2: 2 patients </span><span>– </span><span>L3: 2 patients </span><span>– </span><span>L4: 4 patients </span><span>– </span><span>L5: 6 patients </span><span>– </span><span>S1: 8 patients), 6 patients had broken screws following trauma, while 20 patients were found spontaneous, all patients were found intraoperatively to have posterolateral fixation, they underwent redo screw fixation,18 patients underwent redo screw fixation with posterolateral interbody fusion (PLIF) while the other 8 patients underwent redo screws fixation with posterolateral fixation. All patients with </span><span>PLIF didn’t come back with </span><span>broken screws, while 2 patients with posterolateral fixation came back with broken screws again<br /> </span><span>Conclusion: </span><span>posterolateral interbody fusion (PLIF) may have a rule in preventing broken screw in the management of lumbar spondylolisthesis.<br /> </span>
Authors and Affiliations
Eman Helal
Keywords
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