Failure in Lumbar Spinal Fusion and Current Management Modalities

Alex Cruz; Alexander E. Ropper; David S. Xu; Michael Bohl; Edward M. Reece; Sebastian J. Winocour; Edward Buchanan; Geoffrey Kaung

doi:10.1055/s-0041-1726102

Seminars in Plastic Surgery, Inhaltsverzeichnis

Semin Plast Surg 2021; 35(01): 054-062
DOI: 10.1055/s-0041-1726102

Review Article

Failure in Lumbar Spinal Fusion and Current Management Modalities

Autoren

Alex Cruz

¹Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas
Alexander E. Ropper

²Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
David S. Xu

²Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
Michael Bohl

³Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
Edward M. Reece

²Department of Neurosurgery, Baylor College of Medicine, Houston, Texas

⁴Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
Sebastian J. Winocour

⁴Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
Edward Buchanan

⁴Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

⁵Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
Geoffrey Kaung

¹Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas

Abstract

Lumbar spinal fusion is a commonly performed procedure to stabilize the spine, and the frequency with which this operation is performed is increasing. Multiple factors are involved in achieving successful arthrodesis. Systemic factors include patient medical comorbidities—such as rheumatoid arthritis and osteoporosis—and smoking status. Surgical site factors include choice of bone graft material, number of fusion levels, location of fusion bed, adequate preparation of fusion site, and biomechanical properties of the fusion construct. Rates of successful fusion can vary from 65 to 100%, depending on the aforementioned factors. Diagnosis of pseudoarthrosis is confirmed by imaging studies, often a combination of static and dynamic radiographs and computed tomography. Once pseudoarthrosis is identified, patient factors should be optimized whenever possible and a surgical plan implemented to provide the best chance of successful revision arthrodesis with the least amount of surgical risk.

Keywords

lumbar spinal fusion - neurosurgery - spine surgery - pseudoarthrosis

Volltext

Referenzen

References
1 Albee FH. Transplantation of a portion of the tibia into the spine for Pott's disease. J Am Med Assoc 2007; 460: 14-6
2 Rajaee SS, Bae HW, Kanim LE, Delamarter RB. Spinal fusion in the United States: analysis of trends from 1998 to 2008. Spine 2012; 37 (01) 67-76
3 Burchardt H, Enneking WF. Transplantation of bone. Surg Clin North Am 1978; 58 (02) 403-427
4 Kalfas IH. Principles of bone healing. Neurosurg Focus 2001; 10 (04) E1
5 Khan SN, Cammisa Jr FP, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafting. J Am Acad Orthop Surg 2005; 13 (01) 77-86
6 Berman D, Oren JH, Bendo J, Spivak J. The effect of smoking on spinal fusion. Int J Spine Surg 2017; 11 (04) 29
7 Daftari TK, Whitesides Jr TE, Heller JG, Goodrich AC, McCarey BE, Hutton WC. Nicotine on the revascularization of bone graft. An experimental study in rabbits. Spine 1994; 19 (08) 904-911
8 Theiss SM, Boden SD, Hair G, Titus L, Morone MA, Ugbo J. The effect of nicotine on gene expression during spine fusion. Spine 2000; 25 (20) 2588-2594
9 Glassman SD, Anagnost SC, Parker A, Burke D, Johnson JR, Dimar JR. The effect of cigarette smoking and smoking cessation on spinal fusion. Spine 2000; 25 (20) 2608-2615
10 Carlson BB, Burton DC, Jackson RS, Robinson S. Recidivism rates after smoking cessation before spinal fusion. Orthopedics 2016; 39 (02) e318-e322
11 Kurd MF, Kreitz T, Schroeder G, Vaccaro AR. The role of multimodal analgesia in spine surgery. J Am Acad Orthop Surg 2017; 25 (04) 260-268
12 Kinsella J, Moffat AC, Patrick JA, Prentice JW, McArdle CS, Kenny GN. Ketorolac trometamol for postoperative analgesia after orthopaedic surgery. Br J Anaesth 1992; 69 (01) 19-22
13 Li J, Ajiboye RM, Orden MH, Sharma A, Drysch A, Pourtaheri S. The effect of ketorolac on thoracolumbar posterolateral fusion: a systematic review and meta-analysis. Clin Spine Surg 2018; 31 (02) 65-72
14 Pradhan BB, Tatsumi RL, Gallina J, Kuhns CA, Wang JC, Dawson EG. Ketorolac and spinal fusion: does the perioperative use of ketorolac really inhibit spinal fusion?. Spine 2008; 33 (19) 2079-2082
15 Prolo DJ. Biology of bone fusion. Clin Neurosurg 1990; 36: 135-146
16 Grabowski G, Cornett CA. Bone graft and bone graft substitutes in spine surgery: current concepts and controversies. J Am Acad Orthop Surg 2013; 21 (01) 51-60
17 Ong KL, Villarraga ML, Lau E, Carreon LY, Kurtz SM, Glassman SD. Off-label use of bone morphogenetic proteins in the United States using administrative data. Spine 2010; 35 (19) 1794-1800
18 Simmonds MC, Brown JV, Heirs MK. et al. Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion: a meta-analysis of individual-participant data. Ann Intern Med 2013; 158 (12) 877-889
19 Fu R, Selph S, McDonagh M. et al. Effectiveness and harms of recombinant human bone morphogenetic protein-2 in spine fusion: a systematic review and meta-analysis. Ann Intern Med 2013; 158 (12) 890-902
20 Bodalia PN, Balaji V, Kaila R, Wilson L. Effectiveness and safety of recombinant human bone morphogenetic protein-2 for adults with lumbar spine pseudarthrosis following spinal fusion surgery: a systematic review. Bone Joint Res 2016; 5 (04) 145-152
21 Carragee EJ, Hurwitz EL, Weiner BK. A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine J 2011; 11 (06) 471-491
22 Carragee EJ, Chu G, Rohatgi R. et al. Cancer risk after use of recombinant bone morphogenetic protein-2 for spinal arthrodesis. J Bone Joint Surg Am 2013; 95 (17) 1537-1545
23 Cahill KS, McCormick PC, Levi AD. A comprehensive assessment of the risk of bone morphogenetic protein use in spinal fusion surgery and postoperative cancer diagnosis. J Neurosurg Spine 2015; 23 (01) 86-93
24 Fritzell P, Hägg O, Wessberg P, Nordwall A. Swedish Lumbar Spine Study Group. Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine 2002; 27 (11) 1131-1141
25 Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine 1997; 22 (24) 2807-2812
26 Matz PG, Meagher RJ, Lamer T. et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J 2016; 16 (03) 439-448
27 Santoni BG, Hynes RA, McGilvray KC. et al. Cortical bone trajectory for lumbar pedicle screws. Spine J 2009; 9 (05) 366-373
28 Tortolani PJ, Stroh DA. Cortical bone trajectory technique for posterior spinal instrumentation. J Am Acad Orthop Surg 2016; 24 (11) 755-761
29 Cunningham BW, Sefter JC, Hu N, Kim SW, Bridwell KH, McAfee PC. Biomechanical comparison of iliac screws versus interbody femoral ring allograft on lumbosacral kinematics and sacral screw strain. Spine 2010; 35 (06) E198-E205
30 How NE, Street JT, Dvorak MF. et al. Pseudarthrosis in adult and pediatric spinal deformity surgery: a systematic review of the literature and meta-analysis of incidence, characteristics, and risk factors. Neurosurg Rev 2019; 42 (02) 319-336
31 Kaiser MG, Eck JC, Groff MW. et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 17: bone growth stimulators as an adjunct for lumbar fusion. J Neurosurg Spine 2014; 21 (01) 133-139
32 Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015; 1 (01) 2-18
33 Ghogawala Z, Dziura J, Butler WE. et al. Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis. N Engl J Med 2016; 374 (15) 1424-1434
34 Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J 2006; 6 (04) 435-443
35 Kwon B, Kim DH. Lateral lumbar interbody fusion: Indications, outcomes and complications. J Am Acad Orthop Surg 2016; 24 (02) 96-105
36 Silvestre C, Mac-Thiong JM, Hilmi R, Roussouly P. Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lumbar interbody fusion in 179 patients. Asian Spine J 2012; 6 (02) 89-97
37 Quillo-Olvera J, Lin GX, Jo HJ, Kim JS. Complications on minimally invasive oblique lumbar interbody fusion at L2-L5 levels: a review of the literature and surgical strategies. Ann Transl Med 2018; 6 (06) 101
38 Zdeblick TA. A prospective, randomized study of lumbar fusion. Preliminary results. Spine 1993; 18 (08) 983-991
39 Christensen FB, Hansen ES, Eiskjaer SP. et al. Circumferential lumbar spinal fusion with Brantigan cage versus posterolateral fusion with titanium Cotrel–Dubousset instrumentation: a prospective, randomized clinical study of 146 patients. Spine 2002; 27 (23) 2674-2683
40 Chun DS, Baker KC, Hsu WK. Lumbar pseudarthrosis: a review of current diagnosis and treatment. Neurosurg Focus 2015; 39 (04) E10
41 Teng I, Han J, Phan K, Mobbs R. A meta-analysis comparing ALIF, PLIF, TLIF and LLIF. J Clin Neurosci 2017; 44: 11-17
42 Kornblum MB, Fischgrund JS, Herkowitz HN, Abraham DA, Berkower DL, Ditkoff JS. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine 2004; 29 (07) 726-733 , discussion 733–734
43 Carpenter CT, Dietz JW, Leung KY, Hanscom DA, Wagner TA. Repair of a pseudarthrosis of the lumbar spine. A functional outcome study. J Bone Joint Surg Am 1996; 78 (05) 712-720
44 Choudhri TF, Mummaneni PV, Dhall SS. et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 4: radiographic assessment of fusion status. J Neurosurg Spine 2014; 21 (01) 23-30
45 Brodsky AE, Kovalsky ES, Khalil MA. Correlation of radiologic assessment of lumbar spine fusions with surgical exploration. Spine 1991; 16 (6, Suppl): S261-S265