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Complications with the variable spinal plating system.

T S Whitecloud1, J C Butler, J L Cohen

  • 1Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

Spine
|April 1, 1989
PubMed
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Transpedicle fixation and fusion using the variable spinal plate system showed mixed results in 40 patients. While effective for certain conditions, the overall complication rate was 45%, particularly higher in patients with prior surgery.

Area of Science:

  • Orthopedic Surgery
  • Spinal Fusion
  • Biomedical Engineering

Background:

  • Transpedicle fixation and fusion is a surgical technique for spinal stabilization.
  • The variable spinal plate system is one such device used in these procedures.
  • Assessing outcomes and complications is crucial for refining surgical indications and techniques.

Purpose of the Study:

  • To evaluate the efficacy and complication rates of transpedicle fixation and fusion using the variable spinal plate system.
  • To compare outcomes between patients with and without previous spinal surgery.
  • To identify specific spinal conditions where this technique is most indicated.

Main Methods:

  • A retrospective review of 40 patients who underwent transpedicle fixation and fusion with the variable spinal plate system between January 1986 and June 1987.

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  • Patients were categorized based on previous surgical history (19 revision, 21 primary).
  • Diagnostic categories included spondylolisthesis, fractures, disc derangement, stenosis, pseudarthrosis, instability, and mal-union, with a minimum follow-up of 14 months.

    • Main Results:

    • Overall results were rated as excellent (13), good (12), fair (7), and poor (8).
    • The overall complication rate was 45%, with 29% in primary surgeries and 63% in revision surgeries.
    • Implant failure (screw breakage) occurred in seven patients; design modifications may mitigate this.

    Conclusions:

    • Transpedicle fixation and fusion with the variable spinal plate system is technically demanding with a high complication rate, especially in revision cases.
    • The technique is indicated for specific conditions including lumbar fractures, pseudarthrosis revision, spondylolisthesis, and severe instability after failed surgery.
    • Further design improvements are needed to minimize implant-related complications like screw breakage.