What is the risk for pseudarthrosis following surgery for idiopathic scoliosis?

Updated: Dec 02, 2020
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Pseudarthrosis is a complication that represents a basic failure of the central intention of scoliosis surgery: bone fusion. Luckily, pseudarthrosis is very rare in modern scoliosis surgery. This is in small part due to excellent stable internal fixation (scoliosis instrumentation systems) and in large part due to proper attention to fusion technique.

Pseudarthrosis may be suggested by persistent pain, progressive deformity, or broken hardware. Previously, tomographic plain x-rays (tomograms) were commonly used to image suspected pseudarthrosis. This is no longer the case; such tomography equipment is on the endangered species list of imaging devices. Computed tomography (CT) may be helpful, but clinical suspicion and fusion mass exploration (a rare case for modern-day exploratory surgery) remain the cornerstones of pseudarthrosis diagnosis and treatment.


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