• Philip K. Louie
  • Bryce A. Basques
  • Nicollette M. Pepin
  • Grant D. Shifflett


Pseudarthrosis is a well-known complication in minimally invasive fusion techniques of the spine. As a major cause of failed lumbar spinal surgery, patients often present with significant back pain and disability due to pseudarthrosis. Fortunately, the rates of fusion for minimally invasive techniques are high and similar to those of standard open techniques. A comprehensive understanding of the fusion process will aid surgeons inoptimizing the index procedure in hopes of preventing pseudarthrosis. Furthermore, establishing the diagnosis of symptomatic lumbar pseudarthrosis can often be challenging as symptoms can be initially vague. This requires careful correlation between the clinical presentation and radiologic studies, typically dynamic plain film radiographs and thin-cut CT scan with reconstructions. Once the diagnosis of pseudarthrosis is made, various conservative and surgical treatments can be considered. Conservative treatments typically involve activity modification in combination with core strengthening and aerobic exercises. Surgical treatments are individually based on assessment of spinal balance, previous treatments, hardware stability, pseudarthrosis morphology, and graft options.


Revision fusion Instability Electrical stimulation Interbody fusion Circumferential fusion Atrophic pseudarthrosis Hypertrophic pseudarthrosis 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Philip K. Louie
    • 1
  • Bryce A. Basques
    • 1
  • Nicollette M. Pepin
    • 2
  • Grant D. Shifflett
    • 3
  1. 1.Department of Orthopaedic SurgeryRush University Medical CenterChicagoUSA
  2. 2.University of California, IrvineSan DiegoUSA
  3. 3.DISC Sports & Spine CenterMarina Del ReyUSA

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