Management of postoperative Complications after posterior lumber spinal fixation

Background: For increasing safety and reducing complications that may occur with Trans-Pedicular Scre Placement, different ways have been reported including application of C-arm X-ray view, application of axial computed tomography scan (CTS), frameless stereotactically guided screw placement and different guidance devices. However, the application of all these devices and techniques are not so easy and even in many operating rooms such kinds of instruments are not available. A posterior approach to anterior and middle column reconstruction is often preferred in the lumbar spine for two reasons, the first is that the morbidity associated with an anterior approach is significant and delays recovery, the second is that pedicle screws and rods or plates can be placed before dural retraction and dissection of the intervertebral disk. Aim of the Work: The aim of this work was to evaluate the postoperative Complications. In posterior lumber transpedicular fixation and their management. Patients and Methods: Retrospective and prospective study for evaluating the history, clinical state, laboratory investigations, radiological findings and way of management in 25 cases of postoperative Complications after posterior lumber spinal fixation. Results: 25 patients operated upon for posterior lumbar fixation were included in the present work, In the current work we divided complications of posterior lumbar fixation into intraoperative complications and postoperative complications, Among the 25 patients of our work we had 5 cases of intraoperative complications (20 %) and 20 cases of postoperative complications (80%), Dural tear was the most common intraoperative complications (8%), instrument failure was the most common postoperative complications 12 cases (48%). Conclusion: According to medical history smoking was statistically significant risk factor for intraoperative complications; significant epidural bleeding and dural tear. Hypertension was statistically significant risk factor for intraoperative complications; inappropriate screw insertion and fracture pedicle. Also, smoking was Statistically significant risk factor for development of postoperative complications; infection, C.S.F leak, infection, nerve root injury and pseudoarthrosis.