Learning objectives
To describe the different types of spinal instrumentation including interbody,
anterior and posterior fusion devices,
their correct position,
radiological appearance andpotential complications
Background
Treatment of back pain is the third most common indication for surgical procedures.
Decompression and occasional arthrodesis with instrumentation are frequently performed.
Postoperative imaging is used to assess disease progression,
positioning of instrumentation,
possible complications and the extent of bone-graft fusion.
Knowledge of the advantages and limitations of different imaging modalities is necessary for optimal evaluation of patients with spinal instrumentation.
Radiologists should be familiar with the different surgical methods used in spinal fusion,
types of instrumentation and potential complications to properly appraise postoperative images.
Imaging findings OR Procedure details
There must be adequate fixation to immobilize the spine while the bone graft heals to the vertebral segments.
The purpose of the spine instrumentation is to provide stability and reduce deformity and pain during the fusion process,
and should be keep in mind that is not designed to replace the bony elements of the spine.
Spinal instrumentation may eventually fail unless bone fusion takes place.
Over the past decades,
spinal instrumentation techniques have significantly increased.
Various diagnostic imaging techniques play an important role in the...
Conclusion
Adequate understanding of various surgical techniques and instruments,
coupled with improved awareness of the possible complications,
are vital when interpreting postoperative studies
Radiologists should be familiar with postoperative spinal images obtained on various modalities and the knowledge of how certain situations contribute to failed back surgery syndrome,
and should arrive at a precise diagnosis,
permitting appropriate treatment and minimizing patient suffering.
References
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Denis F,
Perra JH,
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Complications associated with pedicle screws.
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(2) Ray CD.
Ray CD.
Threaded fusion cages for interbody fusion: an economic comparison with 360 degree fusions.
Spine .
Spine 1997;27:681–5.
(3) David T.
Lumbar disc prosthesis: 5 years follow-up study on 147 patients with 163 SB Charité prostheses.
Presented at the fourth annual meeting of the Spine Society of Europe,
Nantes,
France,
September 11–14,
2002.
(4) Van Ooij A,
Oner FC,
Verbout AJ....
Personal Information
Eloísa Santos Armentia
Radiology Department
Povisa Hospital
Salamanca Street number 5
Vigo (Pontevedra) ,
Spain
mail:
[email protected]
[email protected]
Noelia Silva Priegue
Radiology Department
Povisa Hospital
Salamanca Street number 5
Vigo (Pontevedra) ,
Spain
mail:
[email protected]