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We highlight how the need for local control outpaces the risk of instrumentation failure.
Instrumentation failure is a recognized complication after complex spinal reconstruction and deformity correction.
Decreased bone density is an independent risk factor for instrumentation failure in spinal fusion operations.
Osteoporosis and osteomalacia are significant risk factors for fracture and spine instrumentation failure.
The addition of posterior instrumentation after anterior fixation has been shown to increase the overall stiffness of fused segments and decrease the likelihood of instrumentation failure.
Instrumentation failure occurs by either of primary mechanisms, implant failure or bony failure.
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Clinical investigations describe a higher risk of instrument failure in short segment instrumentation with increased preoperative kyphotic deformity in osteoporotic patients [ 21].
After instrumentation, respiratory failure was induced by repeated saline lavage (50 ml/kg; 37°C) as described by Lachmann and colleagues [ 17].
The single-armed expandable pedicle screw design could not outperform a standard pedicle screw in a pullout test performed in a synthetic model; however, the more gradual decrease in axial load following pullout observed with the expandable screw may potentially result in a higher level of stability as the patient waits for revision surgery in the case of instrumentation's failure.
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