Complications of transpedicular reduction and stabilization of the thoracolumbar spine

Between July 1990 and January 1994, 160 patients underwent transpedicular reduction and stabilization using an AO internal fixator. In this series, most of the patients (101 cases) had degenerative spondylolisthesis. The follow-up period ranged from 12 to 36 months. One hundred and thirty one patients (82%) had a good or excellent postoperative outcome. Sixteen (10%) had fair outcomes and 13 (8%) had poor outcomes. There were 26 complications (16%) secondary to this treatment. Improper screw placement was found in five patients, wound infection in four patients and dural tear with cerebrospinal fluid leakage in two patients. Two patients were suspected of having an iatrogenic root injury during the insertion of the pedicle screws. One patient with advanced spondylosis developed a postoperative neurologic deficit (foot drop). In the follow-up period, there was loss of correction of the alignment in five patients, screw breakages in three patients, screw pull-out in two patients and loosening of the clamps in another two patients. As most of the complications were preventable or treatable, pedicle fixation system is still highly recommended for the treatment of spondylolisthesis or spinal instability.