Complications with K-wire insertion for percutaneous pedicle screws

Area of Science:

• Spinal surgery
• Minimally invasive spine techniques
• Orthopedic surgery

Background:

• Percutaneous pedicle screw stabilization is increasingly used for various spinal pathologies.
• Complication rates associated with these minimally invasive techniques are not well-documented.

Purpose of the Study:

• To assess the risk profile of anterior vertebral body breach by Kirschner (K)-wire.
• To identify complications related to K-wire breaches during percutaneous pedicle screw insertion.

Main Methods:

• Retrospective review of 525 consecutive percutaneous pedicle screw insertions.
• Recorded anterior vertebral body breaches and associated clinical outcomes.

Main Results:

• Seven anterior breaches occurred in 525 insertions.
• Breaches were categorized as minor (<5 mm), moderate (5-25 mm), or major (>25 mm).
• Two patients experienced postoperative ileus and retroperitoneal hematoma; no reoperations or transfusions were needed.

Conclusions:

• Minimally invasive spinal fusion indications are expanding.
• The rate of anterior K-wire breach is low but necessitates specialized surgical skills and awareness of potential complications.