J Korean Fract Soc.  2004 Apr;17(2):191-196. 10.12671/jkfs.2004.17.2.191.

Treatment of Vertebral Pseudarthrosis after Compression Fracture

• Koh YD
• Jeong H

• KMID: 2184067
• DOI: http://doi.org/10.12671/jkfs.2004.17.2.191

Abstract

PURPOSE: To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it.
MATERIALS AND METHODS
Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked.
RESULTS
In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees
CONCLUSION
The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.

Keyword

Spine; vertebral pseudarthrosis; Avascular necrosis of vertebral body; Posterior fusion

MeSH Terms

Back Pain
Follow-Up Studies
Fractures, Compression*
Humans
Magnetic Resonance Imaging
Necrosis
Pseudarthrosis*
Spine
Vacuum
Visual Analog Scale