Defining pseudoarthrosis in the cervical spine with differing motion thresholds.
METHODS
Calculate the apparent pseudarthrosis rate for anteriorly plated cervical spine fusions using different threshold levels of intervertebral rotation.


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


BACKGROUND
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.
Hipp
John A
JA
Baylor College of Medicine, Department of Orthopedic Surgery, Houston, Texas, USA. jhipp@bcm.tmc.edu
Reitman
Charles A
CA
Wharton
Nicholas
N
D001860:Bone Plates; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007593:Joint Instability / Q000175:diagnosis* / Q000503:physiopathology; D009068:Movement / Q000502:physiology*; D011183:Postoperative Complications; D011542:Pseudarthrosis / Q000175:diagnosis* / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D013123:Spinal Fusion; D021801:Zygapophyseal Joint / Q000473:pathology / Q000503:physiopathology