Pseudarthrosis Two Years After ACDF May Be a “Delayed Union”? Interesting

A somewhat surprising finding turns out also to be practical and helpful

What’s the Claim?

A very interesting observational study evaluated the fate of pseudarthrosis starting 2 years after ACDF, and found:

  • 33% of them went on to fuse sometime between 2 and 5 years (CT scans were performed only at 2 and 5 years)
  • The patients who initially had pseudarthrosis but went on to successful union by 5 years had patient-reported outcomes scores that continued to improve (VAS neck pain, VAS arm pain, and Neck Disability Index scores), and had better outcomes scores than did the group with a persistent pseudarthrosis at 5 years

CORRelations’ advisor in Spine, Charlie Reitman, MD, felt this study was both interesting and relevant, since

These were all done as plated fusions with cortical allograft and autograft bone shavings. While there is some variation in contemporary fusion technique, allograft fusion with plate is fairly common and representative of current treatment.

How’s It Stack Up?