Management of Complications of Posterior Lumber Spine Fixation for Spondylolithesis

Abstract

This study was aiming at identifying the varieties, causes, treatment and prevention of post lumbar instrumental fixation complications, which was done on a study population of 50 cases, without stratification on bases of sex or age, excluding the patients with known chronic debilitating diseases. Regarding the patients’ population, our demographics shows a clear role of obesity in the pathogenesis of spondylolisthesis in general, regardless of age or sex, the mean BMI was above 30, and this does indeed agree with most studies as mentioned before. Analyzing our results, we found the most affected levels to be L4-5, and L5-S1, which coincides with other studies discussed before, we also found significant dominance of back pain as a presenting complaint, while neurological deficits were rare, by analyzing the etiologies of pathological findings in our patients we found isthmic lythesis followed by spondylolisthesis as the most common etiologies respectively among the studied population.Regarding the positive finding requiring further management in our study, the most common finding was failed prosthesis, and adjacent segment failure, other less frequent findings include Sacroiliac dysfunction, posterior cage migration, screw malpostioning, infection, Dural tear, CSF leak, pseudarthrosis, and one patient with pseudo-meningocele.32 patients (64%) were managed surgically, while the other 18 patients (36%) were managed conservatively, 40 patients had improved complaints, while 10 cases didn’t improve, our results should be seen in the light that our sample size was small, which can be a great limiting factor.