Complications of pediatric thoracolumbar and lumbar pedicle screws

Study Design. This was a retrospective review of 223 consecutive cases (1986-1996) from one institution where 759 thoracolumbar and lumbar pedicle screws were used in the treatment of various pediatric spinal disorders in patients less than 18 years of age. Objectives. To determine the incidence of short- and long-term (>2 years follow-up) complications in this group of patients - specifically, complications related to instrumentation and those directly attributable to pedicle screws in these pediatric patients. Summary of Background Data. Although much has been written regarding the use of pedicle screws in the adult population, no published study has examined complication rates with regard to thoracolumbar and lumbar pedicle screws placed for pediatric spinal disorders. Methods. A retrospective review of 223 consecutive cases involving 759 pedicle screws placed for a variety of pediatric spinal disorders was performed. Complications were divided into short term and long term (>2 years follow-up) and into those relating to instrumentation and those relating to pedicle screws specifically. Results. Short-term complication occurred in 5 patients (2.2%) for a total of 17 screws ultimately removed. Only two of these patients had screws removed for lumbar radicular complaints. No residual sequellae resulted. No long-term (>2 years postoperative) complications were noted. Conclusion. Low short- and long-term complication rates specific for pediatric pedicle screws suggests that for properly trained spinal surgeons, pedicle screw fixation in the pediatric population can be performed safely to treat a variety of spinal disorders.