Analysis of correlation between the pedicular screw diameter to pedicle width ratio and the rate of fusion and surgery complications in Posterior Lumbar Interbody Fusion surgery

Abstract

Stabilization of the lumbar spine with pedicle screws is one of the most common and widely used surgical procedures for patients with spinal deformities. This surgery increases the rate of fusion,but it may be associated with a higher rate of complications.There are limited data on mean pedicle diameter or estimated pedicle screw lengths.Most of the currently available scientific documents suggest the use of screws with a diameter of 80% of the pedicle width. However, the contradictions between the available scientific documents remind us of the need to determine new parameters for determining the size of the screws used. Therefore, in this study, we decided to evaluate the correlation between the pedicular screw diameter to pedicle width ratio and the rate of fusion and surgery complications in Posterior Lumbar Interbody Fusion surgery

.Methods: This randomized clinical trial study was conducted in the neurosurgery department of Imam Reza Hospital in Tabriz from July 2018 to July 2021. 30 patients’ candidate’s posterior lumbar spine surgeries were included in the study. In these patients, the ratio of the width of the screw to the width of the vertebral pedicle and the rate of complications related to surgery were investigated in the follow-up of the patients.Data were analyzed by SPSS version 20. A P-Value of < 0.05 was considered as statistically significant Results: The patients had the same conditions in terms of demographic characteristics. Based on the overlap of the width of the vertebral pedicle, 18 patients had an overlap between 50 and 75% and 12 patients had an overlap of more than 75% of the width of the vertebral pedicle. Screw diameters approximately 80% of the pedicle width The results showed that patients with more than 75% overlap have complications such as vertebral fracture and CSF leak. In the study of postoperative complications showed 2 cases of patients with screw fracture and reoperation, 2 cases of infection, 1 case of rod fracture and 1 case CSF leak.