Defining pseudoarthrosis in the cervical spine with differing motion thresholds

Spine (Phila Pa 1976). 2005 Jan 15;30(2):209-10. doi: 10.1097/01.brs.0000151011.32573.f1.

Abstract

Study design: Calculate the apparent pseudarthrosis rate for anteriorly plated cervical spine fusions using different threshold levels of intervertebral rotation.

Objectives: Determine whether the apparent pseudarthrosis rate depends on the amount of intervertebral rotation used to characterize a fusion as a pseudarthrosis.

Summary of background data: Intervertebral motion at a spine fusion site is an important outcome measure in most spine fusion research studies. Intervertebral motion measures are used to determine if a device can be sold for use in spine fusion surgery. There is no consensus on how much motion is too much motion at a spine fusion site, and the intervertebral motion threshold that is used to define a pseudarthrosis is arbitrary. There are only limited data on the dependence of the pseudarthrosis rate on the threshold used to define a pseudarthrosis.

Methods: Intervertebral motion at the fusion site was measured from flexion extension radiographs taken 1 year after cervical spine fusion using anterior plates and allograft in 200 patients. The number of cases where intervertebral motion at the fusion site exceeded thresholds between 1 degrees and 4 degrees were calculated. RESULTS.: The apparent pseudarthrosis rate varied from 6% when the intervertebral motion threshold was 4 degrees to 44% when the intervertebral motion threshold was 1 degrees .

Conclusions: The apparent pseudarthrosis rate was highly dependent on the threshold of motion used to define a pseudarthrosis.

MeSH terms

  • Bone Plates
  • Cervical Vertebrae / pathology*
  • Cervical Vertebrae / physiopathology
  • Cervical Vertebrae / surgery
  • Humans
  • Image Processing, Computer-Assisted
  • Joint Instability / diagnosis*
  • Joint Instability / physiopathology
  • Movement / physiology*
  • Postoperative Complications
  • Pseudarthrosis / diagnosis*
  • Pseudarthrosis / physiopathology
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Spinal Fusion*
  • Zygapophyseal Joint / pathology
  • Zygapophyseal Joint / physiopathology