Iraq witnessed major war conflicts with devastating effects on the health care system .War and aftermath consequently affected standards of spine care. Patients with different spine melodies that jeopardize spine stability or neural integrity were stabilized using fracture fixation tools, that are inexpensive and were relatively available. This report describes the current application of short and long pedicle screw-plate constructs as spine stabilizers with analysis of modes of failure . Twenty two patients with grades two and three spondylolisthesis were stabilized with short single level constructs and followed for (5.3-10) years.Four patients had screw or plate failure. Long segment constructs with two segments fixed above and two segments below the index level were applied in eleven trauma and tumor cases with instability and incomplete or impending neurologic injury that jeopardize cord function .Three patients got caudal screws failure.Patients had statistically significant improvement in radiological and patient oriented outcome measures. Attaining the right biomechanical environment is more important than actual metal for fusion success andstability.
