ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021
Pseudarthrosis in adult spine deformity surgery: risk factors and treatment options.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- The Etiology and Treatment of Failed Back Surgery Syndrome in Patients with Primary Lumbar Fixation.Journal of orthopaedic case reports · 2026Article
- Investigating the Relationship Between High Density Lipoprotein Cholesterol and Fusion Outcomes Following Single Level Lumbar Fusion: A Propensity Matched Analysis.Global spine journal · 2026Article
- Different Risk Factors of Rod Fracture between L5-S1 and ≥ L4-5 Levels in Adult Spinal Deformity Surgery.Clinics in orthopedic surgery · 2026Article
- The Impact of Proton Pump Inhibitors on Pseudarthrosis Rates Following Multi-Level Lumbar Fusion.Spine surgery and related research · 2026Article
- Efficacy of Modified Transforaminal Lumbar Interbody Fusion in Three-Planar Correction for Severe Adult Spinal Deformity: Radiographic and Clinical Outcomes.Orthopedic research and reviews · 2026Article
- Adult degenerative scoliosis: challenges in diagnosis, pain management, and surgical decision-making.Frontiers in surgery · 2026Review
- Clinical and Sociodemographic Characterization of Mexican Cohort with Pseudoarthrosis: A Retrospective, Cross-Sectional, and Descriptive Study.Reports (MDPI) · 2025Article
- Risk Factors for Rod Fracture at ≥L4-5 Levels Following Long-Segment Fusion for Adult Spinal Deformity: Results from Segment-Based Analysis.Journal of clinical medicine · 2025Article
- Long-term Titanium mesh cage implant failure after total en bloc spondylectomy due to spinal chondrosarcomaRevista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2025Article
- Developing a risk score to inform the use of rhBMP-2 in adult spinal deformity surgery.Spine deformity · 2025Article
- Hardware failure following multilevel posterior percutaneous fixation using the minimally invasive antepsoas (MIS-ATP) approach in adult spine deformity.Journal of spine surgery (Hong Kong) · 2024Article
- Posterior Corrective Surgery for Type II Congenital Kyphosis: SRS-Schwab Grade 4 Osteotomy or Vertebral Column Resection?Orthopaedic surgery · 2024Observational
- Activity and sports resumption after long segment fusions to the pelvis for adult spinal deformity: survey results of AO Spine members.Spine deformity · 2023Article
- Multiple-Rod Constructs in Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis.Asian spine journal · 2023Article
- Pelvic Fixation With a Quad-Rod Technique Using S2 Alar Iliac and Medialized Entry Iliac Screws for Long Fusion Constructs.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Review
- What Are the Benefits of Lateral Lumbar Interbody Fusion on the Treatment of Adult Spinal Deformity: A Systematic Review and Meta-Analysis Deformity.Global spine journal · 2023Review
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Authors and funding
14 authors.
Funding
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Abstract
purposeHighlight risk factors for pseudarthrosis in long-segment spinal fusions, collect the approaches carried to address this complication.
methodsPatients with ASD and fusion of ≥ 4 levels with minimum follow-up (FU) of ≥ 2 years were included. Full-body X-rays were done preoperatively, < 3 months and ≥ 2 years. Oswestry disability index (ODI), Scoliosis Research Society-22 and SF36 assessed pre- and postoperatively. The relationship between demographic, surgical and radiological variables with the development of pseudarthrosis was evaluated.
resultsOut of 524 patients included, 65 patients (12.4%) developed pseudarthrosis and 53 underwent revision surgery. Notably, 88% of pseudarthrosis cases are associated with fusion length (OR = 1.17, 95% CI = 1.05-1.292, p = 0.004), osteotomy requirement (OR = 0.28, 95% CI = 0.09-0.85, p = 0.025), pelvic fixation (OR = 0.34, 95% CI = 0.13-0.88, p = 0.026) and combined approaches (OR = 3.29, 95% CI = 1.09-9.91, p = 0.034). Sagittal alignment is not related to the rate of pseudarthrosis. Health related and quality of life scores were comparable at last FU between patients revised for pseudarthrosis and those that didn't require revision surgery (ODI = 28% no revision and 30% revision group).
conclusionsPseudarthrosis is not related to malalignment, but with the surgical techniques employed for its treatment. Anterior approaches with anterior support decrease the rate by 30%, while long fusions, osteotomies and pelvic fixation increase its rate.
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