RECOMMENDATIONS FOR PREVENTING POSTOPERATIVE COMPLICATIONS OF TRANSPEDICULAR SCREW FIXATION IN PATIENTS WITH SPINAL DISORDERS
DOI:
https://doi.org/10.15674/0030-59872026153-60Keywords:
spine, thoracic section, lumbar section, transpedicular fixation, complication, prevention, biochemistry, immunologyAbstract
Innovations in spinal surgery have improved technical precision and perioperative efficiency, however, the issue of postoperative complications arising from the use of transpedicular screw fixation (TF) remains a concern. Objective. To develop an algorithmic protocol for reducing the likelihood of postoperative complications in patients undergoing transpedicular screw fixation. Methods. An analysis was conducted of the surgical outcomes o f 2 ,760 p atients w ith d egenerative d iseases, i njuries and deformities of the spine, with radiographic assessment of transpedicular screw (TS) placement, both with and without the use of a 3D navigation system. The patients’ laboratory parameters and the results of 62 intraoperative neurophysiological monitoring sessions were studied. Results. An algorithmic scheme was developed to prevent the development of TS complications and improve the quality of care for patients with spinal disorders: preoperative strategic comprehensive planning, intraoperative monitoring and techniques for precise TS placement, postoperative follow-up, prevention complications. An algorithm for action has been defined in cases of suspicion of an incorrectly placed screw or deterioration in neurological status. The core of the prediction and assessment of the likelihood of postoperative complications is an algorithmized scheme for laboratory examination of patients. Its suitability was verified during the surgical treatment of 30 patients. Conclusions. The algorithm-based protocol developed enables a structured assessment of the risk of complications, the planning of surgical treatment taking into account modern technologies, the monitoring of all critical points, the implementation of an individualized approach for each patient, and the integration of spinal navigation and neuromonitoring of the surgical process, which will minimize complications and have a positive impact on patients’condition, the length of their hospital stay, and the qualityof treatment outcomes.
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Copyright (c) 2026 Stanislav Bondarenko, Oleksandr Barkov, Vladyslav Tuliakov
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