Tamio Nishida

Complications of Lumbar Spinal Fusion with Transpedicular Screw Fixation Systems

We retrospectively analyzed the incidence and variety of associated complications in 54 patients who underwent lumber spinal fusion using transpedicular screw fixation systems. The average operative time was 3 hours 28 minutes with an average blood loss of 376 grams for one level fusion. Intraoperatively fracture of the pedicle during screw insertion occurred in 5.6% of cases. The neural infury rate was 3.7%. Post operative complications included 7.7% screw breakage, 1.9% AW-GC spacer breakage, 1.9% nut loosening and 9.6% screw loosening. Final results included 9.6% pseudoarthrosis and 9.6% delayed union. In all of these unsuccessful union cases the graft bone collapsed and the “disc height” became narrow in the post operative period. We believe that the AW-GC spacer offers mechanical advantages compared with iliac bone strut grafts alone.

Treatment of congenital dislocation of the hip with the functional cast

Eight cases of congenital dislocation of the hip were treated in our hospital with functional cast. Two cases failed in reduction by the Palvic Harness, and 6 cases were not treated before one year old. They were treated with our cast for 8 weeks after manual reduction. This cast enables the patients to move legs cephalad and caudal a little in axillar position. All cases obtained good results.