Survivorship analysis of pedicular fixation systems in the treatment of degenerative disorders of the lumbar spine: a comparison of Cotrel-Dubousset instrumentation and the AO internal fixator.
We retrospectively analyzed the frequency and clinical consequences of pedicular fixation system failure in 50 patients who underwent Cotrel-Dubousset transpedicular instrumentation (CDI), and 46 patients who underwent AO internal fixator (IF) instrumentation for similar indications. After 2 years, 14 implants in the CDI group and 13 in the IF group had failed. The overall probability of implant survival was similar in both groups (CDI, 71.9% versus IF, 71.7%). However, more implant failures were associated with nonunion, loss of reduction, and nerve-root compromise in the IF group (four versus none) than in the CDI group. Implant failure usually occurred after solid fusion, and did not significantly affect the short-term clinical results. Therefore, implant failure does not a priori indicate failure of the operation.
Boos
N
N
Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
Marchesi
D
D
Aebi
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D004868:Equipment Failure; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation*; D013126:Spinal Nerve Roots; D013314:Stress, Mechanical