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- Title
Functional computed tomography scanning for evaluating fusion status after anterior cervical decompression fusion.
- Authors
Ouchida, Jun; Yukawa, Yasutsugu; Ito, Keigo; Machino, Masaaki; Inoue, Taro; Tomita, Keisuke; Kato, Fumihiko
- Abstract
<bold>Introduction: </bold>Nonunion is a major complication of anterior cervical fusion that causes poor outcomes and occasionally requires additional operative intervention. The purpose of this study is to evaluate the accuracy of functional computed tomography (CT) scanning for determining fusion status after anterior cervical fusion by comparing with functional radiographs.<bold>Materials and Methods: </bold>The fusion status in 59 patients treated by anterior cervical fusion was assessed by functional radiography and functional CT scanning at 6 and 12 months after surgery. Fusion rates and clinical symptoms were evaluated. Fusion on functional radiography was defined as less than 2 mm of motion between adjacent spinous processes and a particular bony trabeculation on functional CT; fusion was defined as nonexistence of a clear zone or a gas pattern and a particular bone connection on reconstructed sagittal-view images.<bold>Results: </bold>Functional radiographs demonstrated solid fusion in 83.9% at 6 months and 91.1% at 12 months postoperatively; functional CT showed solid fusion in 55.3 and 78.6%, respectively. The fusion rate detected on functional CT images was significantly lower than that on functional radiographs at each period. At 6 months postoperatively, patients with incomplete union on functional CT were more likely to have neck pain than those who had complete union on functional CT. (46.2 vs 13.3%, P < 0.05) CONCLUSION: Functional CT can detect nonunion more clearly than functional radiography. At 6 months postoperatively, patients with incomplete union on functional CT images were likely to have more neck pain. Functional CT may allow accurate detection of symptomatic nonunion after anterior cervical fusion.
- Subjects
COMPUTED tomography; SPINAL fusion; SURGICAL decompression; PSEUDARTHROSIS; NECK pain; SAGITTAL curve; CHI-squared test; CERVICAL vertebrae radiography; CERVICAL vertebrae; SPINE diseases; TREATMENT effectiveness; SURGERY
- Publication
European Spine Journal, 2015, Vol 24, Issue 12, p2924
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-014-3722-z