Pseudarthrosis of the Cervical Spine: Risk Factors, Diagnosis and Management

Overview

Journal Asian Spine J

Date 2016 Aug 26

PMID 27559462

Citations 39

Authors

Dante Leven

Samuel K Cho

Affiliations

Soon will be listed here.

Abstract

Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis.

Citing Articles

Surgical technique of 3D computer-assisted navigated posterior fixation of the upper cervical spine: illustration of three cases.

Altorfer F, Avrumova F, Paschal G, Burkhard M, Lebl D J Spine Surg. 2024; 10(3):521-539.

PMID: 39399079 PMC: 11467279. DOI: 10.21037/jss-24-26.

Challenges in Contemporary Spine Surgery: A Comprehensive Review of Surgical, Technological, and Patient-Specific Issues.

Mensah E, Chalif J, Baker J, Chalif E, Biundo J, Groff M J Clin Med. 2024; 13(18).

PMID: 39336947 PMC: 11432351. DOI: 10.3390/jcm13185460.

Treating Multilevel Cervical Degenerative Disk Disease in a Patient With Stage IV Lung Cancer With Notable Comorbidities Using a Drug Eluting Biomaterial: A Case Report.

Margulies B, Loy J, Thakur N, Sanz-Altamira P J Am Acad Orthop Surg Glob Res Rev. 2024; 8(9).

PMID: 39312687 PMC: 11421713. DOI: 10.5435/JAAOSGlobal-D-24-00051.

Novel Approach to Difficult Spinal Reconstruction: Bilateral Simultaneous Rib and Iliac Crest Vascularized Bone Graft Spinoplastic Surgery.

Shvedova M, Abdulwadood I, Vernik D, Shrout M, Jeger J, Buchanan D Plast Reconstr Surg Glob Open. 2024; 12(4):e5656.

PMID: 38596584 PMC: 11000760. DOI: 10.1097/GOX.0000000000005656.

Does Bone Morphogenetic Protein Use Reduce Pseudarthrosis Rates in Single-Level Transforaminal Lumbar Interbody Fusion Surgeries?.

Zhong J, Tareen J, Ashayeri K, Leon C, Balouch E, OMalley N Int J Spine Surg. 2024; 18(2):207-216.

PMID: 38569928 PMC: 11287818. DOI: 10.14444/8590.

References

BRODSKY A, Khalil M, Sassard W, Newman B . Repair of symptomatic pseudoarthrosis of anterior cervical fusion. Posterior versus anterior repair. Spine (Phila Pa 1976). 1992; 17(10):1137-43. DOI: 10.1097/00007632-199210000-00002. View

Yoon S, Hashimoto R, Raich A, Shaffrey C, Rhee J, Riew K . Outcomes after laminoplasty compared with laminectomy and fusion in patients with cervical myelopathy: a systematic review. Spine (Phila Pa 1976). 2013; 38(22 Suppl 1):S183-94. DOI: 10.1097/BRS.0b013e3182a7eb7c. View

Buchowski J, Liu G, Bunmaprasert T, Rose P, Riew K . Anterior cervical fusion assessment: surgical exploration versus radiographic evaluation. Spine (Phila Pa 1976). 2008; 33(11):1185-91. DOI: 10.1097/BRS.0b013e318171927c. View

Lowery G, Swank M, McDonough R . Surgical revision for failed anterior cervical fusions. Articular pillar plating or anterior revision?. Spine (Phila Pa 1976). 1995; 20(22):2436-41. DOI: 10.1097/00007632-199511001-00012. View

Lee J, Lee S, Peters C, Riew K . Risk-factor analysis of adjacent-segment pathology requiring surgery following anterior, posterior, fusion, and nonfusion cervical spine operations: survivorship analysis of 1358 patients. J Bone Joint Surg Am. 2014; 96(21):1761-7. DOI: 10.2106/JBJS.M.01482. View

Heller J, Edwards 2nd C, Murakami H, Rodts G . Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: an independent matched cohort analysis. Spine (Phila Pa 1976). 2001; 26(12):1330-6. DOI: 10.1097/00007632-200106150-00013. View

Buttermann G . Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliac-crest autograft in anterior cervical discectomy and fusion. Spine J. 2007; 8(3):426-35. DOI: 10.1016/j.spinee.2006.12.006. View

Eubanks J, Thorpe S, Cheruvu V, Braly B, Kang J . Does smoking influence fusion rates in posterior cervical arthrodesis with lateral mass instrumentation?. Clin Orthop Relat Res. 2010; 469(3):696-701. PMC: 3032837. DOI: 10.1007/s11999-010-1575-2. View

Newman M . The outcome of pseudarthrosis after cervical anterior fusion. Spine (Phila Pa 1976). 1993; 18(16):2380-2. DOI: 10.1097/00007632-199312000-00002. View

10.

Van Eck C, Regan C, Donaldson W, Kang J, Lee J . The revision rate and occurrence of adjacent segment disease after anterior cervical discectomy and fusion: a study of 672 consecutive patients. Spine (Phila Pa 1976). 2014; 39(26):2143-7. DOI: 10.1097/BRS.0000000000000636. View

11.

RILEY Jr L, Robinson R, Johnson K, WALKER A . The results of anterior interbody fusion of the cervical spine. Review of ninety-three consecutive cases. J Neurosurg. 1969; 30(2):127-33. DOI: 10.3171/jns.1969.30.2.0127. View

12.

Song K, Johnson J, Choi B, Wang J, Lee K . Anterior fusion alone compared with combined anterior and posterior fusion for the treatment of degenerative cervical kyphosis. J Bone Joint Surg Br. 2010; 92(11):1548-52. DOI: 10.1302/0301-620X.92B11.24995. View

13.

Rao R, Gourab K, David K . Operative treatment of cervical spondylotic myelopathy. J Bone Joint Surg Am. 2006; 88(7):1619-40. DOI: 10.2106/JBJS.F.00014. View

14.

Zdeblick T, Ducker T . The use of freeze-dried allograft bone for anterior cervical fusions. Spine (Phila Pa 1976). 1991; 16(7):726-9. DOI: 10.1097/00007632-199107000-00006. View

15.

Hilibrand A, Fye M, Emery S, Palumbo M, Bohlman H . Impact of smoking on the outcome of anterior cervical arthrodesis with interbody or strut-grafting. J Bone Joint Surg Am. 2001; 83(5):668-73. DOI: 10.2106/00004623-200105000-00004. View

16.

Callahan R, Johnson R, MARGOLIS R, Keggi K, Albright J, Southwick W . Cervical facet fusion for control of instability following laminectomy. J Bone Joint Surg Am. 1977; 59(8):991-1002. View

17.

Fehlings M, Smith J, Kopjar B, Arnold P, Yoon S, Vaccaro A . Perioperative and delayed complications associated with the surgical treatment of cervical spondylotic myelopathy based on 302 patients from the AOSpine North America Cervical Spondylotic Myelopathy Study. J Neurosurg Spine. 2012; 16(5):425-32. DOI: 10.3171/2012.1.SPINE11467. View

18.

Herkowitz H . A comparison of anterior cervical fusion, cervical laminectomy, and cervical laminoplasty for the surgical management of multiple level spondylotic radiculopathy. Spine (Phila Pa 1976). 1988; 13(7):774-80. DOI: 10.1097/00007632-198807000-00011. View

19.

Woods B, Hohl J, Lee J, Donaldson 3rd W, Kang J . Laminoplasty versus laminectomy and fusion for multilevel cervical spondylotic myelopathy. Clin Orthop Relat Res. 2010; 469(3):688-95. PMC: 3032861. DOI: 10.1007/s11999-010-1653-5. View

20.

Tribus C, Corteen D, Zdeblick T . The efficacy of anterior cervical plating in the management of symptomatic pseudoarthrosis of the cervical spine. Spine (Phila Pa 1976). 1999; 24(9):860-4. DOI: 10.1097/00007632-199905010-00005. View