19 Harley St, London, W1G 9QJ, UK

Pseudarthrosis in primary fusions for adult idiopathic scoliosis: incidence, risk factors, and outcome analysis

STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the incidence, characteristics, risk factors, and Scoliosis Research Society Instrument-24 (SRS-24) outcome scores of pseudarthrosis in adult idiopathic scoliosis primary fusions. SUMMARY OF BACKGROUND DATA: The healing of spinal fusion is complex and difficult to study in a clinical setting. There are no detailed reports on pseudarthrosis in primary fusion for adult idiopathic scoliosis since the introduction of ‘modern’ segmental fixation techniques. METHODS: A retrospective chart and radiographic review of 96 patients (average age 42.2 years; range 18.2-62.9 years) with adult idiopathic scoliosis undergoing first time (primary) spinal instrumentation and fusion with a minimum 2-year follow-up (average 5.9 years; range 2-16.8 years) treated at a single institution between 1985 and 2001 were analyzed. RESULTS: Sixteen patients had pseudarthroses (17%). Fifty-nine percent of the pseudarthroses occurred between T9 and L1, and 81% presented with multiple levels involved (2-6 levels). The site of crosslinks or dominoes correlated with pseudarthrosis site in 69%. Pseudarthroses were detected radiologically at 32.4 months (range 12-67 months) postoperatively. Patient age at surgery more than 55 years significantly correlated with pseudarthrosis (P = 0.007). The number of fused levels more than 12 vertebrae is also significantly correlated with pseudarthrosis (P = 0.03). Smoking history and comorbidity did not increase the pseudarthrosis rate (P = 0.71 and 0.19, respectively). A larger preoperative Cobb angle (> or =70 degrees) and a greater thoracic kyphosis (T5-T12 >40 degrees) did not correlate with a higher pseudarthrosis rate (P = 0.76 and 0.73, respectively). Thoracolumbar kyphosis (T10-L2 > or =20 degrees) correlated with a significantly higher pseudarthrosis rate (P < 0.0001). Preoperative global sagittal and coronal imbalance did not increase the pseudarthrosis rate (P = 0.45 and 0.62, respectively). Patients with pseudarthrosis had lower SRS-24 scores than those without (P = 0.01). CONCLUSION.: The incidence of pseudarthrosis following adult idiopathic scoliosis primary fusion was 17%. The pseudarthrosis was most likely to occur at the thoracolumbar junction. Older patients (>55 years), longer fusion (>12 vertebrae), and those with thoracolumbar kyphosis (> or =20 degrees) demonstrated increased risk for pseudarthrosis. Patients’ outcomes as measured by the SRS-24 were ‘negatively’ affected by the pseudarthrosis

Keywords : Adolescent,Adult,adverse effects,analysis,Chi-Square Distribution,Comorbidity,diagnostic imaging,epidemiology,Female,Follow-Up Studies,history,Humans,Incidence,instrumentation,Kyphosis,Lumbar Vertebrae,Male,methods,Middle Aged,Patients,Pseudarthrosis,Radiography,Retrospective Studies,Risk,Risk Factors,Scoliosis,Smoking,Spinal Fusion,statistics & numerical data,Statistics,Nonparametric,surgery,Thoracic Vertebrae,Time,Treatment Outcome,Universities,Washington,, Primary,Fusions,Adult, new treatment for vulvodynia

Date of Publication : 2005 Feb 15

Authors : Kim YJ;Bridwell KH;Lenke LG;Rinella AS;Edwards C;

Organisation : Washington University Medical Center, St. Louis, Missouri, USA

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/15706346

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Pseudarthrosis in primary fusions for adult idiopathic scoliosis incidence, risk factors, and outcome analysis | Fibromyalgia clinic near me

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

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