Early complications after instrumentation of the lumbar spine using cortical bone trajectory technique

This retrospective chart review aimed to identify and report on a series of early complications that resulted from instrumentation of the lumbar spine using the cortical bone trajectory (CBT) technique. CBT technique is a novel method for fixation of the lumbar spine. Since it was first described in 2009 this technique has gained significant popularity. Here we report a series of early complications that have developed in patients who had lumbar spine fusion using the CBT technique. A retrospective chart review was performed in which all cases utilizing the CBT technique for instrumentation of the lumbar spine by two fellowship trained spine surgeons at our institution between July 2012 and May 2014 were reviewed. Medical records were reviewed to determine the number of patients who went on to develop an early complication after instrumentation with this technique. An early complication was defined as any of the following occurring within 3 months of surgery: (1) early screw loosening confirmed by post-operative CT scan, (2) evidence of fracture development confirmed by post-operative CT scan, (3) intra-operatively identified durotomy, (4) superficial or deep post-operative infection and (5) neurological injury. A total of 22 cases using the CBT technique were performed in our department. Of these cases two patients went onto develop early screw loosening, one developed an intra-operative pars fracture, one developed a dural tear and lastly, one patient developed both a pedicle fracture and early screw loosening. At our institution a total of five patients thus far have developed early complications after undergoing instrumentation of the lumbar spine using the CBT technique between 2012-2014.