[Complication of thoracic pedicle screw fixation in spinal deformities].
OBJECTIVE
To analyze the etiology and prevention of complications related to the pedicle screw technique in the treatment of thoracic scoliosis.


METHODS
There were 183 thoracic deformity patients 110 idiopathic scoliosis, 32 adult scoliosis, 28 congenital kyphoscoliosis, 8 Marfan syndrome with scoliosis, and 6 others. All patients' Cobb angles were evaluated preoperatively, intraoperatively, and postoperatively by roentgenograms. The deformity correction rate was calculated. All radiographic evaluations were carried out in a double-blind fashion. The complication rate was analyzed perioperatively and postoperatively.


RESULTS
The deformity correction rate was 72%, better than others treated with hook-rod system. The perioperation complication rate was 8.4% (pedicle fracture 1.5%, infection 3.8%, pneumothorax and plural effusion 1.6%, transitory neurological damage 0.5%, and over-bleeding shock 1%). The complication rate at follow-up was 3.6% (infection 0.5%, fatigue fracture 1%, loss of deformity correction 1.6%, and transitory neurological damage 0.5%). Compared with those treated with hook-rod system, the perioperation complication rate, loss of deformity correction, permanent damage, and complications related to the internal fixation were all low.


CONCLUSIONS
The complication rate of pedicle screw fixation system was low in the treatment of thoracic deformity. When surgeons are thoroughly familiar with the technique and related pathoanatomy, and with the spinal cord function wardship by SEP, complications related to the pedicle screw technique in the treatment of thoracic scoliosis will be well controlled.
Deng
Youwen
Y
Department of Spine Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China. drywdeng@yahoo.com.cn
Zhou
Yijia
Y
Lu
Guohua
G
Wang
Bing
B
Li
Jing
J
Kang
Yijun
Y
Lu
Chang
C
Liu
Weidong
W
Ma
Zemin
Z
D000293:Adolescent; D000328:Adult; D001863:Bone Screws / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000601:surgery*; D055815:Young Adult