alexa Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of 144 cases.
Neurology

Neurology

Journal of Spine

Author(s): Kim YJ, Bridwell KH, Lenke LG, Rhim S, Cheh G

Abstract Share this page

Abstract STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the incidence of and risk factors for pseudarthrosis in long adult spinal instrumentation and fusion to S1. SUMMARY OF BACKGROUND DATA: Few studies on pseudarthrosis in long adult spinal instrumentation and fusion to S1 exist. METHODS: A clinical and radiographic assessment of 144 adult patients with spinal deformity (average age 52.0 years; range 21.1-77.6) who underwent long (5-17 vertebrae, average 11.9) spinal instrumentation and fusion to the sacrum at a single institution between 1985 and 2002, with a minimum 2-year follow-up (average 3.9; range 2-14) was performed. RESULTS: Of 144 patients, 34 (24\%) had pseudarthroses. There were 17 patients who had pseudarthroses at T10-L2 and 15 at L5-S1. A total of 24 patients (71\%) presented with multiple levels involved (2-6). Pseudarthrosis was most commonly detected within 4 years postoperatively (31 patients; 94\%). Factors that statistically increased the risk of pseudarthrosis were: thoracolumbar kyphosis (T10-L2 > or = 20 degrees vs. < 20 degrees, P < 0.0001); osteoarthritis of the hip joint (P = 0.002); thoracoabdominal approach (vs. paramedian approach, P = 0.009); positive sagittal balance > or = 5 cm at 8 weeks postoperatively (vs. < or = 5 cm, P = 0.012); age at surgery older than 55 years (vs. 55 years or younger, P = 0.019); and incomplete sacropelvic fixation (vs. complete sacropelvic fixation, P = 0.020). Fusion from upper thoracic spine (T2-T5) did not statistically increase the pseudarthrosis rate compared to lower thoracic spine (T9-T12) (P = 0.20). Patients with pseudarthrosis had significantly lower Scoliosis Research Society 24 outcome scores (average score 71/120) than those without (average score 90/120; P < 0.0001) at ultimate follow-up. CONCLUSION: The overall prevalence of pseudarthrosis following long adult spinal deformity instrumentation and fusion to S1 was 24\%. Thoracolumbar kyphosis, osteoarthritis of the hip joint, thoracoabdominal approach (vs. paramedian approach), positive sagittal balance > or = 5 cm at 8 weeks postoperatively, older age at surgery (older than 55 years), and incomplete sacropelvic fixation significantly increased the risks of pseudarthrosis to an extent that was statistically significant. Scoliosis Research Society 24 outcomes scores at ultimate follow-up were adversely affected when pseudarthrosis developed. This article was published in Spine (Phila Pa 1976) and referenced in Journal of Spine

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 18th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    Nov 13-15, 2017, Athens, Greece
  • 2nd International Conference on Pediatric Neurology  
    August 31-September 01, 2017 Prague, Czech Republic
  • 12th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    November 16-18, 2017 Lisbon, Portugal

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords