OBJECTIVE: To determine the factors that influence lumbosacral instrumentation failures following spino-pelvic fusions. METHODS: A retrospective study of patients diagnosed with scoliosis who underwent spinopelvic fusion via posterior, from T2 or T3 proximally to iliac crest, using pedicle and iliac screws. Instrumentation failures were analyzed, and the association of this complication with different parameters was studied. RESULTS: We present 44 patients, with an average age of 24 years, with different etiologies. The mean value of the largest preoperative major curve was 74.2°, and in the final review, it was 67%. The anterior-posterior imbalance, pelvic tilt, thoracic kyphosis, lumbar lordosis and lateral imbalance were significantly improved in the final review. There were instrumentation failures in 41% cases, all at the lumbosacral level. A significant association was found between increased instrumentation failures in patients over 17 years and in patients with independent walking ability. In 24 patients, a bilateral single iliac screw was used and in 20 patients, two or more screws were used. Both groups had a similar incidence of failures. In the group with two or more screws, only rod breakages occurred, without detachment or screw lysis. There was lower instrumentation failure incidence in the patients who underwent L3-S1 interbody fusion or a third rod attached with sublaminar compression hooks. CONCLUSIONS: This series had 41% instrumentation failures, all located at lumbosacral level. There were significant more instrumentation failures in patients with independent walking ability and those aged over 17 years. There was lower instrumentation failure incidence in the patients who underwent L3-S1 interbody fusion or a third rod attached with sublaminar compression hooks.
Scoliosis; Spinal fusion; Bone screws; eatment outcome
