Abstract:Objective To investigate the fate of sclerosis and anterior osteophytes in the fused segments after instrumented lumbar fusion for degenerative lumbar disorders.Methods Thirty patients (9 males,21 females;60 vertebra;mean age of 66.8 years(45~86 years) were divided into a posterolateral fusion group (n=14,28vertebrae) and a posterior lumbar interbody fusion group(n= 16,32 vertebrae).Serial radiographs obtained preoperatively;postoperatively at 3,6,12 and 24 months;and last follow-up,sclerotic areas of each involved vertebra were mapped and osteophyte lengths were measured.Results Sclerosis and osteophytes decreased with time for the instrumented fusion.The decrease in sclerotic areas and osteophytes length was observed as early as 3 months postoperatively;and the significant change between each time point were noted in initial 3-and 6-month intervals.In terms of the type of surgery,similar changes were noted in the posterolateral fusion and posterior lumbar interbody fusion groups.Conclusion Resorption of osteophytes and sclerosis after instrumented spine fusion were observed.Significant resorption was noted at 3 and 6 months postoperatively.Resorption of osteophytes and sclerosis after instrumented spine fusion could be helpful to confirm the successful union.
[1]Frost HM.An approach to estimating bone and joint loads and muscle strength in living subjects and skeletal remains[J].Am J Hum Biol,1999,11(3):437-455.
[2]Riley LH Jr,Robinson RA,Johnson KA,et al.The results of anterior interbody fusion of the cervical spine:review of ninety-three consecutive cases[J].J Neurosurg 1969,30(21):127-133.
[3]Core DR,Gardner GM,Sepic SB,et al.Roentgenographic findings following anterior cervical fusion[J].Skeletal Radiol,1986,15(7):556-559.
[4]Ha KY,Na KH,Shin JH,et al.Comparison of posterolateral fusion with and without additional posterior interbody fusion for degenerative lumbar spondylolisthesis[J].J Spinal Disord Tech,2008,21(7):229-234.
[5]Kim KH,Park JY,Chin DK.Fusion criteria for posterior lumbar interbody fusion with intervertebral cages:the significance of traction spur[J].J Korean Neurosurg Soc,2009,46(11):328-332.
[6]Seo JY,Ha KY.Fate of posterior osteophytes in fused segments after anterior cervical discectomy and fusion[J].Spine,2012,37(2):755-758.
[7]Larsen JM,Rimoldi RL,Capen DA,et al.Assessment of pseudarthrosis in pedicle screw fusion:a prospective study comparing plain radiographs,flexion/extension radiographs,CT scanning,and bone scintigraphy with operative findings[J].J Spinal Disord Tech,1996,9(2):117-120.
[8]Ha KY,Kim YH.Bilateral pedicle stress fracture after instrumented posterolateral lumbar fusion:a case report[J].Spine,2003,28(11):158-160.