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Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis.

Publication ,  Journal Article
Elder, BD; Sankey, EW; Theodros, D; Bydon, M; Goodwin, CR; Lo, S-F; Kosztowski, TA; Belzberg, AJ; Wolinsky, J-P; Sciubba, DM; Gokaslan, ZL ...
Published in: J Clin Neurosci
February 2016

Pseudarthrosis occurs after approximately 2-20% of anterior cervical discectomy and fusion (ACDF) procedures; it is unclear if posterior or anterior revision should be pursued. In this study, we retrospectively evaluate the outcomes in 22 patients with pseudarthrosis following ACDF and revision via posterior cervical fusion (PCF). Baseline demographics, preoperative symptoms, operative data, time to fusion failure, symptoms of pseudarthrosis, and revision method were assessed. Fusion outcome and clinical outcome were determined at last follow-up (LFU). Thirteen females (59%) and 9 (41%) males experienced pseudarthrosis at a median of 11 (range: 3-151)months after ACDF. Median age at index surgery was 51 (range: 33-67)years. All patients with pseudarthrosis presented with progressive neck pain, with median visual analog scale (VAS) score of 8 (range: 0-10), and/or myeloradiculopathy. Patients with pseudarthrosis <12 months compared to >12 months after index surgery were older (p=0.013), had more frequent preoperative neurological deficits (p=0.064), and lower baseline VAS scores (p=0.006). Fusion was successful after PCF in all patients, with median time to fusion of 10 (range: 2-14)months. Eighteen patients fused both anteriorly and posteriorly, two patients fused anteriorly only, and two patients fused posteriorly only. Median VAS neck score at LFU significantly improved from the time of pseudarthrosis (p=0.012). While uncommon, pseudarthrosis may occur after ACDF. All patients achieved successful fusion after subsequent posterior cervical fusion, with 91% fusing a previous anterior pseudarthrosis after posterior stabilization. Neck pain significantly improved by LFU in the majority of patients in this study.

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Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

February 2016

Volume

24

Start / End Page

57 / 62

Location

Scotland

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Retrospective Studies
  • Reoperation
  • Pseudarthrosis
  • Neurology & Neurosurgery
  • Neck Pain
  • Middle Aged
  • Male
  • Humans
 

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Elder, B. D., Sankey, E. W., Theodros, D., Bydon, M., Goodwin, C. R., Lo, S.-F., … Witham, T. F. (2016). Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis. J Clin Neurosci, 24, 57–62. https://doi.org/10.1016/j.jocn.2015.07.019
Elder, Benjamin D., Eric W. Sankey, Debebe Theodros, Mohamad Bydon, C Rory Goodwin, Sheng-Fu Lo, Thomas A. Kosztowski, et al. “Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis.J Clin Neurosci 24 (February 2016): 57–62. https://doi.org/10.1016/j.jocn.2015.07.019.
Elder BD, Sankey EW, Theodros D, Bydon M, Goodwin CR, Lo S-F, et al. Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis. J Clin Neurosci. 2016 Feb;24:57–62.
Elder, Benjamin D., et al. “Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis.J Clin Neurosci, vol. 24, Feb. 2016, pp. 57–62. Pubmed, doi:10.1016/j.jocn.2015.07.019.
Elder BD, Sankey EW, Theodros D, Bydon M, Goodwin CR, Lo S-F, Kosztowski TA, Belzberg AJ, Wolinsky J-P, Sciubba DM, Gokaslan ZL, Bydon A, Witham TF. Successful anterior fusion following posterior cervical fusion for revision of anterior cervical discectomy and fusion pseudarthrosis. J Clin Neurosci. 2016 Feb;24:57–62.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

February 2016

Volume

24

Start / End Page

57 / 62

Location

Scotland

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Retrospective Studies
  • Reoperation
  • Pseudarthrosis
  • Neurology & Neurosurgery
  • Neck Pain
  • Middle Aged
  • Male
  • Humans