[Spinal Fusion, Microdiscectomy & Laminectomy Procedures] Subsequent Vertebral Fractures Following Spinal Fusion Surgery for Degenerative Lumbar Disease: A Mean Ten-Year Follow-up

[Justin]

Spine. Volume 35(21), 1 October 2010, pp 1915-1918

Subsequent Vertebral Fractures Following Spinal Fusion Surgery for Degenerative Lumbar Disease: A Mean Ten-Year Follow-up

Toyone, Tomoaki MD; Ozawa, Tomoyuki MD; Kamikawa, Koya MD; Watanabe, Atsuya MD; Matsuki, Keisuke MD; Yamashita, Takeshi MD; Shiboi, Ryutaro MD; Takeuchi, Masato MD; Wada, Yuichi MD; Inada, Kunimasa MD; Aoki, Yasuchika MD; Inoue, Gen MD; Ohtori, Seiji MD; Tanaka, Tadashi MD. Author Information: From the Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan. © 2010 Lippincott Williams & Wilkins, Inc.

Study Design. Case-control study.

Objective. To assess the long-term prevalence of vertebral fractures after lumbar spinal fusion with instrumentation.

Summary of Background Data. The incidence of the adjacent and the nonadjacent, remote level subsequent vertebral fractures after lumbar spinal fusion is not well described in the literature.

Methods. The study is a retrospective analysis of 100 consecutive patients of 55 years of age or older with spinal fusion for degenerative diseases between L1 and S1, and instrumentation for less than 4 segments. Patients with prevalent vertebral fractures defined at the time of surgery, or patients with secondary causes of osteoporosis were excluded. Mean follow-up period was 10.2 years (range, 7–14 years). Acute vertebral fractures were determined by magnetic resonance imaging and lateral spine radiographs.

Results. Acute vertebral fractures were determined in 20 vertebrae in 14 (24%) of the 59 female patients, whereas 1 male patient (2%) had 1 vertebral fracture during the follow-up period. Eighteen of the 21 fractures occurred within 2 years of the spinal instrumentation surgery. Regarding time to fracture occurrence after surgery, adjacent level fractures occurred within 8 months, and remote level fractures occurred between 8 and 22 months after surgery.

Conclusion. Postmenopausal female patients who underwent lumbar spinal instrumentation surgery were susceptible to develop subsequent vertebral fractures within 2 years after surgery. The greater the number of spinal segments between the fracture and the instrumentation was, the longer the time after surgery.

[Gilbert P]

Hi Justin

Were these fusions done with screws? If so would it make sense to have the screws removed after solid fusion to prevent Fractures?

The reason I ask is when I have my fusion, I would have my hardware removed after solid fusion,Its just me I do not like hardware in my body .I have had all the previous screws and pins removed after bone healed.

Thanks for the recent information

Gil