Fusion surgery is often performed after a damaged disc has been removed to help restore spine stability and reduce pain levels. The failure of a spinal fusion, however, is certainly possible following surgery.
When this happens, it is referred to as pseudoarthrosis or nonunion of the bone. This means your spinal fusion surgery has been unsuccessful. Pseudoarthrosis may also result from other factors related to your lifestyle, and fortunately, there are some treatments that can be used to treat it.
What is Pseudoarthrosis?
Pseudoarthrosis is a condition that causes bones to not fuse properly, leading to delayed healing of the broken bones. This can happen after a fracture (break) of the bone, poor healing of the bones following surgery, or an abnormality of the spine.
The fracture site fails to fuse, and bony growth forms at the fracture site. The abnormally fused bones may break again if there is trauma to the area.
What Are the Causes of Pseudoarthrosis?
There are many potential causes of pseudoarthrosis. The most common cause of a non-union is poor bone healing following a fusion procedure performed by your surgeon. Complications from spinal fusion surgery can cause pseudarthrosis such as bone loss, swelling, and loss of blood flow.
Fusion surgery can fail because of the patient’s lifestyle habits and physical conditions. A poor diet, alcohol consumption, and diseases such as diabetes or infection can increase the risk of developing pseudoarthrosis.
Symptoms of Pseudoarthosis
If you experience pseudoarthrosis after a spinal fusion fracture, in many cases, pain is often the first symptom you’ll notice. Depending on the location of your injury, you may feel pain at the site of the fracture or at areas surrounding it. There may be pain when pressure is placed on the affected area or when you try to move around such as walking.
Pseudarthrosis can be compared to osteoarthritis in terms of many of the symptoms that are associated. Other symptoms that may be experienced include:
- Joint stiffness
- Numbness and tingling sensations in certain joints and injured body part(s)
- Sensation that something is wrong with your injured body parts, even if nothing appears to be wrong upon visual examination
- Inability to do certain activities that were previously performed without difficulty.
Treatment for Pseudoarthrosis
Sometimes surgery is necessary, but doctors typically recommend conservative treatments first. The most likely conservative treatments for pseudoarthrosis are medications, physical therapy, and pain management.
Conservative treatment generally consists of rest and pain management, along with physical therapy exercises to help strengthen the muscles around the injury. Doctors may also prescribe medications, including non-steroidal anti-inflammatory drugs (NSAIDs), to control pain and swelling.
When non-surgical treatments have been unsuccessful at eliminating symptoms or if the patient is experiencing severe pain, surgery may be recommended.
Recommended Surgeries for Pseudoarthrosis
If surgery is necessary, there are several different kinds of procedures that can be used to treat pseudoarthrosis.
Fixation devices
Internal fixation devices like screws and plates may be used in conjunction with bone grafting to promote the growth of new bone tissue. External fixation is another method that may be used to treat pseudoarthrosis, although it isn’t as common as internal fixation. With external fixation, metal pins are inserted into the bone above and below where the break occurred in order to stabilize it while healing occurs naturally over time.
Bone transport
Bone transport may also be used in the treatment of pseudoarthrosis. Bone transport involves inserting a metal rod into the bone and stretching it over a period of time until enough new bone has grown to replace what was originally missing.
Electrical stimulation
Electromagnetic waves or ultrasonic waves work to stimulate the synthesis of bone cells. In the next stage, the cells form the hydroxyapatite structure in order to prevent fractures and bending.
Bone grafts
Structural bone grafts offer an alternative treatment option for those who do not respond well or would prefer not to undergo surgery at all due to personal reasons such as age or health status. However, they are an expensive option when compared with other types of surgical procedures available today.
How To Know If Surgery Is Necessary
Only a qualified spinal surgeon can determine if you will benefit from surgery. Generally speaking, it is final option after conservative treatment has failed.
