Spinal instrumentation with a low complication rate

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedic Surgery

Background:

• Spinal instrumentation is increasingly used in neurosurgery, with higher complication rates reported compared to non-instrumented procedures.
• Previous studies indicate complication rates including neurologic injury (2-3%), implant failure reoperation (3-45%), and infection (5-10%).
• This study focuses on a series of spinal instrumentation cases performed exclusively by neurosurgeons.

Purpose of the Study:

• To evaluate the complication rate and outcomes of spinal instrumentation exclusively performed by neurosurgeons.
• To determine the safety and efficacy of spinal instrumentation in a neurosurgical practice.
• To compare the observed complication and fusion rates with previously reported data.

Main Methods:

• Analysis of 299 consecutive spinal instrumentation cases performed by neurosurgeons at Indiana University Medical Center.
• Instrumentation types included anterior cervical locking plates, posterior cervical instrumentation, anterior/posterior thoracolumbar plates, and posterior thoracolumbar instrumentation.
• Complications related to spinal instrumentation were systematically recorded and analyzed.

Main Results:

• A mean follow-up of 40 months revealed a low overall complication rate of 3% (10/299 cases) and a reoperation rate of 2%.
• No neurologic injuries or hardware infections were reported; other complications included dural tears and superficial wound infections.
• The arthrodesis (fusion) rate was exceptionally high at 99% (298/299).

Conclusions:

• Spinal instrumentation performed by neurosurgeons can achieve complication rates lower than previously reported.
• Lessons learned can further reduce complication rates, highlighting the safety and utility of spinal instrumentation.
• Spinal instrumentation is a safe and effective adjunct for spinal fusion in treating degenerative, traumatic, infectious, and neoplastic conditions.