Many types of spinal instrumentation have been developed and are widely used for treating a range of spinal disorders such as injuries, tumors and degenerative disease. However varions complicatios have been found to arise after the use of these instruments.
We investigated the cause of operative and post-operative complications associated with the use of spinal instruments (Kaneda device 14, Harrington 5, A-O pedicular screw 15, Diapason 4, compact CD3, Spine system 1) in 41 patients (27 meals, 14 females).
5 cases showed loosening of the nut, and 4 cases had hook deviation when using the Kaneda device. One case of screw penetration, one case of increasing kyphosis, one case of screw breakage, one case of MRSA infection, 3 cases of projection of the posterior edge of the screw causing pain were seen with the A-O system. One case of screw breakage was seen with the Spine system and there was one pedicular fracture associated with Diapason.
Both patients with broken screws started sports or their job 4 or 5 weeks postoperatively. The patient who had screw penetration had been taking steroids for sarcoidosis for 13 years. Osteoporosis was found in the patient with increasing kyphosis. The abnormal position of the pedicular screw was not seen in post-poerative roentgenograms in three cases.
We conclude that the cause of pedicular fracture is due to operative technique, the cause of screw penetration is due to operative indication, the cause of screw breakage is due to early activity by the patients, projection of the posterior screw edge is due to instrumental structure, and MRSA infection is due to sterility of the opertation.