caa a22 4500 445831758 CHVBK 20180317145317.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00586-011-1739-0 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1739-0 Extension CT scan: its suitability for assessing fusion after posterior lumbar interbody fusion [Elektronische Daten] [Hiroaki Nakashima, Yasutsugu Yukawa, Keigo Ito, Yumiko Horie, Masaaki Machino, Shunsuke Kanbara, Daigo Morita, Shiro Imagama, Naoki Ishiguro, Fumihiko Kato] Posterior lumbar interbody fusion (PLIF) is a popular procedure for treating lumbar canal stenosis with spinal instability, and several reports concerning fusion assessment methods exist. However, there are currently no definitive criteria for diagnosing a successful interbody fusion in the lumbar spine. We suggested evaluating fusion status using computed tomography (CT) in extension position to detect pseudoarthrosis more precisely. The purpose of this study was to evaluate its usefulness for determining bone union quality after PLIF. Eighty-one patients who underwent PLIF at 97 levels were retrospectively enrolled. The study population included 48 men and 33 women (mean age 58.9years, range 21-85years). Patients were followed up for more than 12months after surgery. The mean follow-up period was 27.6months (range 14-49months). Fusion status was evaluated using three ways: flexion-extension radiographs, CT images in flexion and extension position. In the flexion-extension radiographs, mobility of more than 3°, a remaining clear zone, or an uncertain bone connection constituted an incomplete union. For CT images, a remaining clear zone, a gas pattern, or an uncertain bone connection constituted an incomplete union. Flexion-extension radiographs demonstrated a solid fusion in 90.7% of the 97 levels at 10.7months postoperatively. When fusion was demonstrated on flexion-extension radiographs, the rate of fusion affirmed by flexion CT and extension CT was 87.6 and 69.1% of the levels assessed, respectively. The rate of pseudoarthrosis detected on extension CT images was significantly higher than that on flexion-extension radiographs (P<0.001) and flexion CT (P<0.01). The rate of fusion achieved on extension CT was 85.6% at 15.1months postoperatively. Extension CT could detect pseudoarthrosis more clearly than flexion-extension radiography and flexion CT. The CT images are influenced by body position and dilating anterior disc space in extension CT contributes to detect pseudoarthrodesis. Thus, extension CT was a useful method for assessing fusion status after PLIF. Springer-Verlag, 2011 Extension CT nationallicence Flexion-extension radiograph nationallicence Interbody fusion nationallicence Fusion rate nationallicence Radiographic assessment nationallicence Nakashima Hiroaki Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut Yukawa Yasutsugu Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Ito Keigo Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Horie Yumiko Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Machino Masaaki Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Kanbara Shunsuke Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Morita Daigo Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut Imagama Shiro Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut Ishiguro Naoki Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut Kato Fumihiko Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut European Spine Journal Springer-Verlag 20/9(2011-09-01), 1496-1502 0940-6719 20:9<1496 2011 20 586 https://doi.org/10.1007/s00586-011-1739-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1739-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakashima Hiroaki Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Yukawa Yasutsugu Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Ito Keigo Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Horie Yumiko Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Machino Masaaki Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Kanbara Shunsuke Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Morita Daigo Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 700 1- Imagama Shiro Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Ishiguro Naoki Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, 466-8560, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kato Fumihiko Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/9(2011-09-01), 1496-1502 0940-6719 20:9<1496 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer