19 Harley St, London, W1G 9QJ, UK

Contribution of MRI and Imaging Exams in the Diagnosis of Lumbar Pseudarthrosis – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article discusses the diagnosis of pseudoarthrosis, which is the absence of fusion in spinal surgery. The standard diagnostic approach involves post-operative observation through CT scans and patient symptoms. Additional imaging techniques such as dynamic x-rays and PET-CT can also be used. However, there is no universally accepted diagnostic approach among spine practitioners. The study aims to describe the timeline and diagnostic analysis for pseudoarthrosis between the initial surgery and follow-up procedure. The research found that plain X-rays, dynamic X-rays, CT scans, and MRI can all contribute to the diagnosis of pseudarthrosis. The authors suggest that MRI can be used in combination with CT to optimize the diagnosis and shorten the time to revision surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated day surgery spinal centre in the world

Published article

: Reducing the time to reintervention is a key objective for improving the management and clinical outcomes of these patients. We suggest that MRI is an additional tool in combination with CT in the assessment of suspected mechanical pseudarthrosis, in order to optimize the diagnosis and shorten the time to revision surgery.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Orthop Traumatol Surg Res. 2024 Jan 19:103817. doi: 10.1016/j.otsr.2024.103817. Online ahead of print.ABSTRACTINTRODUCTION: The diagnosis of pseudoarthrosis is based on imaging and clinical exam findings. The standard for pseudarthrosis diagnosis remains post-operative observation through computer tomography (CT) and patient’s symptoms. This can be further augmented by dynamic x-ray imaging or nuclear positron emission tomography (PET),

Orthop Traumatol Surg Res. 2024 Jan 19:103817. doi: 10.1016/j.otsr.2024.103817. Online ahead of print.

ABSTRACT

INTRODUCTION: The diagnosis of pseudoarthrosis is based on imaging and clinical exam findings. The standard for pseudarthrosis diagnosis remains post-operative observation through computer tomography (CT) and patient’s symptoms. This can be further augmented by dynamic x-ray imaging or nuclear positron emission tomography (PET) CT to demonstrate an absence of fusion by showing a persistence of mobility. However, there is not a uniform diagnostic approach that is a standard of care amongst spine practioners. The aim of this study is to describe the timeline and diagnostic analysis for pseudoarthrosis between the initial surgery and follow-up procedure.

METHODS: This is a single-center retrospective observational study. The aim was to enroll patients reoperated for pseudarthrosis after 1 or 2 level lumbar fusions, between August 1, 2008 and August 1, 2018.The exams were reviewed by one surgeon and one radiologist, defining a status either in favor of pseudarthrosis, or against it, or inconclusive, based on the radiological criteria mentioned below.We then investigated different combinations of exams and their specific chronology before a diagnosis was established.

RESULTS: 44 patients were included, 70.5% male and with a mean age of 47.3 years. The median time between the 2 surgeries was 23.7 months. Plain X-rays supported the diagnosis in 38.7% of cases, dynamic X-rays showed hypermobility in 50% of cases. The CT scan demonstrated pseudarthrosis in 94,4% of cases. A MODIC 1 signal was observed in 87,2% of cases on MRI. SPECT-CT showed a tracer uptake in 70% of cases.

: Reducing the time to reintervention is a key objective for improving the management and clinical outcomes of these patients. We suggest that MRI is an additional tool in combination with CT in the assessment of suspected mechanical pseudarthrosis, in order to optimize the diagnosis and shorten the time to revision surgery.

LEVEL OF EVIDENCE: IV.

PMID:38246489 | DOI:10.1016/j.otsr.2024.103817

The London Spine Unit : best situated day surgery spinal centre in the world

Read the original publication:

Contribution of MRI and Imaging Exams in the Diagnosis of Lumbar Pseudarthrosis

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Orthop Traumatol Surg Res. 2024 Jan 19:103817. doi: 10.1016/j.otsr.2024.103817. Online ahead of print.ABSTRACTINTRODUCTION: The diagnosis of pseudoarthrosis is based on imaging and clinical exam findings. The standard for pseudarthrosis diagnosis remains post-operative observation through computer tomography (CT) and patient's symptoms. This can be further augmented by dynamic x-ray imaging or nuclear positron emission tomography (PET)

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810