Early surgery-related complications after anteroposterior stabilization of vertebral body fractures in the thoracolumbar region.
BACKGROUND
The complication rate after trauma-associated spine surgery remains unknown because of the rarity of this injury and the polymorphism of treatment methods. We report the complication rates recorded at one center after treatment of unstable vertebral body fractures according to a single, uniform procedure. The aim of this analysis was to identify the typical complications associated with this surgical procedure and, consequently, to contribute to critical deliberations on the introduction of technical innovations such as navigation, intraoperative three-dimensional imaging, and neuromonitoring.


METHODS
Perioperative complications related to surgery of 208 consecutive patients, operated on for unstable vertebral body fractures were analyzed. First, stabilization was performed through an open, posterior, nonnavigated approach. This was followed, in all patients, by reconstruction of the anterior column form with a tricortical iliac crest graft during a second operation.


RESULTS
In regard to posterior stabilization, at least one pedicle screw in six patients (3%) was placed incorrectly; furthermore, there were five patients with general complications, all of which required revision surgery. After anterior spondylodesis, there were also nine general complications and five neurological complications, one of them in a patient with persistent paraplegia. At the graft donor site, three patients experienced an avulsion fracture of the anterosuperior iliac crest. Overall, at least one complication occurred in 13% of patients (confidence interval 0.08-0.18).


CONCLUSIONS
With regard to early complications, two-stage anteroposterior stabilization of unstable spinal fractures of the thoracolumbar spine is a reliable procedure.
Konstantinidis
Lukas
L
Department of Orthopaedics and Traumatology, Albert Ludwigs University Freiburg, Hugstetter Strasse 55, Freiburg, 79106, Germany.
Mayer
Elisabeth
E
Strohm
Peter C
PC
Hirschmüller
Anja
A
Südkamp
Norbert Paul
NP
Helwig
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013904:Thoracic Vertebrae / Q000293:injuries*; D055815:Young Adult