Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion. A roentgen stereophotogrammetric and radiographic analysis.
To determine the influence of the duration of postoperative lumbar immobilization with the aid of a rigid lumbar orthosis on the consolidation of posterolateral lumbosacral fusions, 22 patients with no previous osseous spinal surgery and with fusion without osteosynthesis due to spondylolysis-olisthesis Grade 1 to 2 or intervertebral disc or facet joint disorder were examined by roentgen stereophotogrammetric analysis in supine and erect positions and by conventional radiography for 1 year after surgery. In Series 1, patients (n = 11) were instructed to keep the trunk straight with the aid of a molded, rigid lumbar orthosis for 5 months after surgery; and in Series 2 (n = 11), the same instructions were given, but for 3 months. In Series 1, osseous fusion was seen on radiographs in eight patients. In these patients, the intervertebral translations between the fused vertebrae began to decrease 3-6 months after surgery, and within 1 year, the fusions became rigid, as defined by roentgen stereophotogrammetric analysis, or intervertebral translations of mostly less than 1 mm persisted. In three patients with poor fusion still seen on radiographs 1 year after surgery, no rigid fusion was obtained and intervertebral translations of up to 10 mm persisted. In Series 2, a similar roentgen stereophotogrammetric analysis pattern was noted in two patients with osseous fusion and in seven with poor fusion seen on radiographs. The fusion was radiographically doubtful in two patients. In these patients, the intervertebral translations decreased, but translations of 1.5 mm persisted 1 year after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Johnsson
R
R
Department of Orthopedics, Lund University Hospital, Sweden.
Strömqvist
B
B
Axelsson
P
P
Selvik
G
G
D000328:Adult; D005260:Female; D006801:Humans; D007103:Immobilization; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D009989:Orthotic Devices; D010780:Photogrammetry; D011182:Postoperative Care; D011859:Radiography; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D013169:Spondylolysis / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors