{"id":"3e6c0293-8b49-4287-b572-f4d29bd2951f","slug":"k-wire-fracture-during-minimally-invasive-transforaminal-lumbar-interbody-fusion-report-of-six-cases-and-recommendations-for-avoidance-and-management","title":"K-Wire fracture during minimally invasive transforaminal lumbar interbody fusion: Report of six cases and recommendations for avoidance and management","authors":["Justin K. Scheer","Michael J. Harvey","Nader S. Dahdaleh","Zachary A. Smith","Richard G. Fessler"],"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).","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/3e6c0293-8b49-4287-b572-f4d29bd2951f/featured/hero-1782420946363.png","publishDate":"2014-12-30T00:00:00.000Z","doi":"10.4103/2152-7806.148009","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/5891/SNI-5-520.pdf"}