K-Wire fracture during minimally invasive transforaminal lumbar interbody fusion: Report of six cases and recommendations for avoidance and management

Justin K. Scheer, Michael J. Harvey, Nader S. Dahdaleh, Zachary A. Smith*, Richard G. Fessler

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: Although rare, minimally invasive spine techniques do have the risk of intraoperative device failure. Kirschner wire (K-wire) fractures during minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) have not been previously reported. This report focuses on the incidence of k-wire fractures following MI-TLIF and describes techniques to help avoid and treat these fractures when they occur. Methods: Inclusion criteria: (i) patients underwent 1, 2, or 3 level MI-TLIF over a 10-year period and (ii) had a k-wire fracture leading to a retained fragment. Exclusion criteria included: >10° coronal curves, significant sagittal malalignment, infection, and preoperative instrumentation failure. Results: Of 513 patients undergoing MI-TLIF, 6 (1.2%) sustained k-wire fracture (3 males, 3 females, mean age 43 ± 13 years). Complications included k-wire fracture alone (4 patients), cerebrospinal fluid (CSF) leak (1 patient), and both ileus and revision for hardware removal (1 patient). All six patients went home postoperatively. The mean follow-up duration was 27.7 ± 37.4 months. All retained k-wire fragments were located in the vertebral bodies at the tip of the pedicle screws; none breached the anterior cortex of the vertebral bodies. None of the k-wires migrated at final follow-up 7.8 years (93.7 months) postoperatively. Furthermore, no complications were attributed to retained k-wires. Conclusions: K-wire fractures during MI-TLIF are rare (incidence of 1.2%) and retained k-wire segments led to no postoperative complications (e.g. no migration).

Original languageEnglish (US)
Pages (from-to)S520-S522
JournalSurgical Neurology International
Volume5
Issue number15
DOIs
StatePublished - Dec 30 2014

Keywords

  • Complications
  • K-wire
  • Kirschner wire
  • Minimally invasive
  • TLIF
  • Transforaminal lumbar interbody fusion

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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