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Fate of Osteophytes and Sclerosis in Fused Segments After Lumbar Fusion

Ha, Kee-Yong MD; Molon, Jan Noel MD; Ahn, Joo-Hyun MD; Kim, Young-Hoon MD

doi: 10.1097/BRS.0000000000000454
Surgery

Study Design. Retrospective cohort study.

Objective. To investigate the fate of sclerosis and anterior osteophytes in the fused segments after instrumented lumbar fusion for degenerative lumbar disorders.

Summary of Background Data. Sclerosis and osteophytosis are well-known radiographical findings, but little is known of their significance with regard to spontaneous resorption after spine fusion.

Methods. Thirty patients (9 males, 21 females; 60 vertebra; mean age of 66.9 yr [45–86 yr]) were divided into a posterolateral fusion group (n = 14, 28 vertebrae) and a posterior lumbar interbody fusion group (n = 16, 32 vertebrae). Using serial radiographs obtained preoperatively; postoperatively at 3, 6, 12, and 24 months; and last follow-up, sclerotic areas of each involved vertebra were mapped and osteophyte lengths were measured.

Results. Sclerosis and osteophytes decreased with time for the instrumented fusion. The decrease in sclerotic areas and osteophytes length was observed as early as 3 months postoperatively, and the significant changes between each time point were noted in initial 3- and 6-month intervals. In terms of the type of surgery, similar changes were noted in the posterolateral fusion and posterior lumbar interbody fusion groups.

Conclusion. Resorption of osteophytes and sclerosis after instrumented spine fusion were observed. Significant resorption was noted at 3 and 6 months postoperatively. As well, most graft bone would be incorporated in postoperative 6 months. Resorption of osteophytes and sclerosis after instrumented spine fusion could be helpful to confirm the successful union.

Level of Evidence: 4

Sixty vertebrae were included to investigate the fate of sclerosis and osteophytes after lumbar fusion in posterolateral fusion and posterior lumbar interbody fusion groups. The highest resorption rates were noted in the first 3 and 6 months after surgery. There was no significant difference, however, in the rates of sclerosis reduction and osteophyte resorption between the 2 types of surgery.

From the Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address correspondence and reprint requests to Kee-Yong Ha, MD, Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, 137-701, Seoul, Korea; E-mail: kyh@catholic.ac.kr

Acknowledgment date: December 22, 2013. First revision date: March 29, 2014. Second revision date: May 7, 2014. Acceptance date: May 9, 2014.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins