Postoperative complications of transpedicular screw fixation in spinal patients.

Abstract

Objective: To determine the frequency and pattern of postoperative complications following transpedicular screw fixation in patients with spinal pathology. Study Design: Descriptive (Cross-sectional) study. Setting: Department of Neurosurgery, Lady Reading Hospital, Peshawar. Period: 1st November 2025 to 30th April 2026. Methods: A total of 133 patients aged 15–80 years who underwent transpedicular screw fixation for spinal pathology were enrolled through non-probability consecutive sampling. Data were collected using a structured proforma, history, clinical examination and postoperative X-rays. Complications recorded included screw breakage, screw misplacement, surgical site infection and neurological deficit. Neurological status was assessed using Frankel Grading. Data were analyzed using SPSS v25; the chi-square test was applied to determine the association between age and complications, with p≤0.05 taken as significant. Results: Of 133 patients, 96 (72.2%) were male and 37 (27.8%) were female. The thoracolumbar region was the most common site of injury. Postoperative complications included back pain (26.3%), surgical site infection (6.8%), misplaced screws (2.3%), screw breakage (1.5%) and nerve root injury (0.75%). On Frankel grading, 61.6% of patients had no neurological deficit (Grade E) postoperatively. No significant association was found between age and postoperative complications (χ²=0.198, p>0.05). Conclusion: Transpedicular screw fixation performed under fluoroscopic guidance is associated with a high rate of favorable outcome and a low rate of technical and neurological complications, although postoperative back pain and surgical site infection remain notable challenges.