Early results of spinal fusion using variable spine plating system

Area of Science:

• Orthopedic Surgery
• Spinal Fusion
• Biomechanical Engineering

Background:

• Variable Spine Plating (VSP) is a surgical technique used for spinal stabilization.
• Many patients undergoing VSP have had prior spinal surgeries.
• Indications for VSP include spinal stenosis, instability, spondylolisthesis, and fractures.

Purpose of the Study:

• To evaluate the outcomes of Variable Spine Plating (VSP) in a consecutive patient series.
• To identify factors influencing the success and complications of VSP.
• To define optimal indications for VSP in spinal surgery.

Main Methods:

• Retrospective analysis of 77 consecutive patients treated with VSP between August 1984 and October 1985.
• Assessment of operative indications, including previous surgeries, spinal stenosis, instability, spondylolisthesis, herniated discs, pseudoarthrosis, fractures, and failed surgery syndrome.
• Evaluation of clinical outcomes using a four-tiered grading system (excellent, good, fair, poor) and analysis of complications such as deep wound infections and screw failures.

Main Results:

• Overall results: 30% excellent, 30% good, 34% fair, 6% poor.
• Complications included 4 deep wound infections and 19 cases of broken screws.
• Twenty-four patients (31%) required reoperation.
• Screw alignment and angular relationship to the plate are critical for minimizing screw failure.

Conclusions:

• VSP can achieve satisfactory outcomes in selected cases of spinal instability.
• Technical factors, particularly screw alignment, are crucial for minimizing hardware failure.
• Recommended indications include moderate to severe instability (spondylolisthesis, failed surgery), obese/deconditioned patients, post-decompression instability, and unstable thoracolumbar fractures.