Revision strategies for lumbar pseudarthrosis.
Management and avoidance of lumbar pseudarthrosis are among the most common and challenging tasks faced by reconstructive spine surgeons. The risks of pseudarthrosis can be broadly divided into two categories: those within a surgeon's control and those not within his/her control. These include biological factors, graft choices, site preparation, and surgical design. The authors review the biological factors that affect fusion and how they can be manipulated to avoid or manage lumbar pseudarthrosis. Surgical planning and construct design to prevent or treat pseudarthrosis will also be discussed. Additionally, the importance of restoring sagittal balance will be reviewed.
Ondra
Stephen L
SL
Department of Neurosurgery, Northwestern University, Chicago, Illinois 60611, USA. songra@nmff.org
Marzouk
Shaden
S
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001696:Biomechanical Phenomena; D016025:Bone Transplantation / Q000379:methods; D015897:Comorbidity; D019299:Decompression, Surgical; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D007085:Ilium / Q000637:transplantation; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D010024:Osteoporosis / Q000453:epidemiology; D010027:Osteotomy; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D011300:Preoperative Care; D011542:Pseudarthrosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D013123:Spinal Fusion; D014945:Wound Healing
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal