OBJECTIVE: To verify the presence of neurological damages in patients submitted to instrumentation with thoracolumbar pedicle screws misplacement. METHODS: Prospective study with a random selection of 30 patients submitted to pedicular instrumentation by posterior approach with freehand technique. Screws vertebral positioning was comparatively and blindly evaluated with tomographies. Then, we tried to correlate neurological status with screws placement. RESULTS: Thirty patients submitted to spinal surgery at this hospital for any disease had instrumentation with 223 pedicle screws. Vertebral pedicle wall violation was observed in 33% of cases, and more than half of them had medial cortical breach. Neurological worsening occurred in three patients in the immediate postoperative period, but only one screw needed repositioning. All patients recovered the previous neurological status. CONCLUSION: A high level of pedicle screw cortical violation was observed. However, small pedicle breaches may originate neurological damages and, when they occur, the lesions are reversible if the misplaced screws are corrected.
Spine; Spinal canal; Bone screws; Spinal fusion; Tomography; Radiculopathy
