Spinal Fusion Surgeries: Can Pedicle Screw Breach Cause Neurological Damage?
Spinal Fusion Surgeries: Can Pedicle Screw Breach Cause Neurological Damage?
Spinal Fusion Surgery can help prevent back pain caused by degenerative disc disease, scoliosis, fractures, or infection of the spine. The vertebrae responsible for the motion that results in pain are joined and stabilized using wires, plates, or rods.

Spinal Fusion Surgeries

Spinal Fusion Surgery can help prevent back pain caused by degenerative disc disease, scoliosis, fractures, or infection of the spine. The vertebrae responsible for the motion that results in pain are joined and stabilized using wires, plates, or rods.

Pedicle screws are used to fix this instrumentation in place. They’re inserted into the anterior vertebrae via the bony lumbar pedicle.

Much like drilling a nail into a wall, inserting a pedicle screw can quickly go sideways. If the screw penetrates in the spinal canal, it could injure the nerves, and cause neurological damage.

Dangers of a Misplaced Pedicle Screw

Be it any place in the world, orthopedic surgeons still mostly perform freehand pedicle screwing. The placement can be checked using lateral fluoroscopy, electronic navigation, electrical testing, or direct inspection. However, even the most specialist orthopedic doctors of Dubai say that it’s possible to miss a misplaced screw at times.

In cases where the screw is misaligned by only one or two millimeters, there is not much to raise concern. However, more inaccurate adjustment can lead to vascular, spinal, and visceral injuries.

A study by Amaral and Payares states that anterior breaches less than 4 millimeters are safe. Another research by Marina and Renata Galindo about neurological impact of misplaced pedicle screw concludes that neurological injury is associated with cortical rupture. The study also noted that cases with screw penetrations over 4 millimeters had to be repositioned to avoid further complications.

Although, a North American Spine Society study revealed that pedicle screw damage is a one-in-a-thousand probability with only 2-3% of infection.