Percutaneous pedicle screw fixation for thoracic and lumbar spine injuries: analysis of errors and complications
- Authors: Kuftov V.S.1, Usikov V.D.2
-
Affiliations:
- Bryansk City Hospital No 1
- Vreden National Medical Research Center of Traumatology and Orthopedics
- Issue: Vol 31, No 4 (2025)
- Pages: 53-65
- Section: СLINICAL STUDIES
- URL: https://journals.rcsi.science/2311-2905/article/view/357893
- DOI: https://doi.org/10.17816/2311-2905-17777
- ID: 357893
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Abstract
Background. Percutaneous pedicle screw fixation is a modern method of stabilizing the thoracic and lumbar spine. Systematic analysis of errors and complications makes it possible to identify risk predictors, improve screw installation techniques, and reduce the incidence of postoperative complications.
The aim of the study — to analyze errors and complications during percutaneous pedicle screw fixation of the thoracic and lumbar spine and to identify risk factors for their development.
Methods. A retrospective study was conducted on 228 patients (median age 38.5 years) with single-level injuries of the thoracic and lumbar spine who underwent surgery between 2003 and 2023. The patients were divided into two groups: the main group, in which reposition of the damaged segment was performed to the calculated target parameters, and the control group, in which target parameters were not calculated. The following factors were assessed: sex, age, time from injury, morphology of injury, neurological status, and volume of surgical intervention. Morphometric parameters were analyzed using CT scans: AVH — anterior vertebral body height; PVH — posterior vertebral body height; angle α — segmental angle; A-VDCH — anterior vertebral-disc complex height; P-VDCH — posterior vertebral-disc complex height. The time to complication onset was analyzed using the Kaplan-Mayer method. The impact of risk factors was assessed by building a regression model.
Results. Complications were detected in 32 (14.0%) patients: intraoperative — in 2 (0.9%), early postoperative — in 8 (3.5%), late (mechanical) — in 22 (9.7%). Statistically significant differences in the incidence of complications were found between the groups (χ2 = 7.471, p = 0.006). The risk of complications in the control group was 3.9 times higher than in the main group (HR = 3.948; 95% CI 1.326-11.757; p = 0.014).
Conclusions. The most common complications were mechanical ones caused by errors in spinal reposition. Restoration of the calculated target parameters, including the measurements of the vertebral-disc complex and segmental angle, significantly reduced the incidence of complications in patients with thoracic and lumbar spine injuries.
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##article.viewOnOriginalSite##About the authors
Vladimir S. Kuftov
Bryansk City Hospital No 1
Author for correspondence.
Email: kuftov@mail.ru
ORCID iD: 0000-0002-0548-8944
SPIN-code: 1558-5875
Cand. Sci. (Med.)
Russian Federation, BryanskVladimir D. Usikov
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: usikov@list.ru
ORCID iD: 0000-0001-7350-6772
SPIN-code: 3499-8679
Dr. Sci. (Med.), Professor
Russian Federation, St. PetersburgReferences
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