Our Summary

This study looked at the occurrence of pseudarthrosis, a condition where the bones do not properly fuse after spinal surgery, in patients who had undergone a specific type of minimally invasive spinal fusion surgery called antepsoas (ATP) lumbar and lumbosacral fusions. The researchers looked back at 220 patients who had this surgery between 2008 and 2019 and had follow-up scans a year after their operation.

They found that 98.3% of the spinal disc levels they looked at had successfully fused after the operation. Only 1.7% had developed pseudarthrosis. The condition was most common in the L5-S1 discs (the lowest part of the spine) and in patients who were smokers. However, only half of the patients with pseudarthrosis had symptoms, and only two patients (0.9% of the total) needed further surgery because of it.

The study concluded that this type of surgery has a high success rate, but that pseudarthrosis is more likely to occur in certain parts of the spine and in smokers.

FAQs

  1. What is pseudarthrosis and how often does it occur in patients after ATP lumbar and lumbosacral fusions?
  2. In which part of the spine is pseudarthrosis most common after ATP lumbar and lumbosacral fusion surgery?
  3. Does smoking increase the risk of developing pseudarthrosis after undergoing ATP lumbar and lumbosacral fusion surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to quit smoking, as it can increase the risk of developing pseudarthrosis after surgery. Additionally, following post-operative instructions carefully and attending all follow-up appointments can help ensure a successful fusion and reduce the risk of complications.

Suitable For

Patients who are typically recommended for lumbar fusion surgery include those with:

  1. Degenerative disc disease
  2. Spondylolisthesis
  3. Spinal stenosis
  4. Herniated discs that have not responded to non-surgical treatment
  5. Vertebral fractures
  6. Failed previous spinal surgeries
  7. Instability in the spine

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if lumbar fusion surgery is appropriate for their specific condition and symptoms.

Timeline

Before lumbar fusion:

  • Patient experiences chronic lower back pain, leg pain, and/or numbness
  • Patient undergoes conservative treatments such as physical therapy, medications, and injections
  • Patient and surgeon decide that lumbar fusion surgery is necessary to stabilize the spine and alleviate symptoms

After lumbar fusion:

  • Patient undergoes pre-operative testing and preparation for surgery
  • Patient undergoes lumbar fusion surgery, which involves removing damaged disc material and fusing the vertebrae together with bone grafts and hardware
  • Patient stays in the hospital for a few days for recovery
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Patient follows up with surgeon for post-operative care and monitoring
  • Patient gradually returns to normal activities, with improvements in pain and function over time.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion surgery include:

  1. What is the success rate of this specific type of lumbar fusion surgery?
  2. What are the potential complications or risks associated with the surgery, such as pseudarthrosis?
  3. Are there any factors that may increase my risk of developing pseudarthrosis, such as smoking?
  4. How will I be monitored for pseudarthrosis after the surgery?
  5. What symptoms should I watch out for that may indicate pseudarthrosis?
  6. What treatment options are available if pseudarthrosis does occur?
  7. How likely is it that I will need additional surgery if pseudarthrosis develops?
  8. Are there any lifestyle changes I should make, such as quitting smoking, to reduce my risk of complications?
  9. What is the typical recovery process after lumbar fusion surgery, and how long does it take to fully heal?
  10. Are there any alternative treatment options to lumbar fusion that I should consider?

Reference

Authors: Tannoury C, Bhale R, Vora M, Saade A, Kortbawi R, Orlando G, Das A, Tannoury T. Journal: Spine (Phila Pa 1976). 2021 Dec 15;46(24):1690-1695. doi: 10.1097/BRS.0000000000004115. PMID: 34474451