Management of anterior cervical pseudarthrosis

Michael G. Kaiser, Praveen V. Mummaneni, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic, Daniel K. Resnick

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Object. The objective of this systematic review was to use evidence-based medicine to identify the best methodology for diagnosis and treatment of anterior pseudarthrosis. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to pseudarthrosis and cervical spine surgery. Abstracts were reviewed, after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Evaluation for pseudarthrosis is warranted, as there may be an association between clinical outcome and pseudarthrosis. The strength of this association cannot be accurately determined because of the variable incidence of symptomatic and asymptomatic pseudarthroses (Class III). Revision of a symptomatic pseudarthrosis may be considered because arthrodesis is associated with improved clinical outcome (Class III). Both posterior and anterior approaches have proven successful for surgical correction of an anterior pseudarthrosis. Posterior approaches may be associated with higher fusion rates following repair of an anterior pseudarthrosis (Class III). Conclusions. If suspected, pseudarthrosis should be investigated because there may be an association between arthrodesis and outcome. However, the strength of this association cannot be accurately determined. Anterior and posterior approaches have been successful.

Original languageEnglish (US)
Pages (from-to)228-237
Number of pages10
JournalJournal of Neurosurgery: Spine
Volume11
Issue number2
DOIs
StatePublished - Aug 1 2009

Fingerprint

Pseudarthrosis
Arthrodesis
Guidelines
Medical Subject Headings
National Library of Medicine (U.S.)
Peer Review
Evidence-Based Medicine
Consensus
Spine
Joints
Databases
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Kaiser, M. G., Mummaneni, P. V., Matz, P. G., Anderson, P. A., Groff, M. W., Heary, R. F., ... Resnick, D. K. (2009). Management of anterior cervical pseudarthrosis. Journal of Neurosurgery: Spine, 11(2), 228-237. https://doi.org/10.3171/2009.2.SPINE08729
Kaiser, Michael G. ; Mummaneni, Praveen V. ; Matz, Paul G. ; Anderson, Paul A. ; Groff, Michael W. ; Heary, Robert F. ; Holly, Langston T. ; Ryken, Timothy C. ; Choudhri, Tanvir F. ; Vresilovic, Edward J. ; Resnick, Daniel K. / Management of anterior cervical pseudarthrosis. In: Journal of Neurosurgery: Spine. 2009 ; Vol. 11, No. 2. pp. 228-237.
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Kaiser, MG, Mummaneni, PV, Matz, PG, Anderson, PA, Groff, MW, Heary, RF, Holly, LT, Ryken, TC, Choudhri, TF, Vresilovic, EJ & Resnick, DK 2009, 'Management of anterior cervical pseudarthrosis', Journal of Neurosurgery: Spine, vol. 11, no. 2, pp. 228-237. https://doi.org/10.3171/2009.2.SPINE08729

Management of anterior cervical pseudarthrosis. / Kaiser, Michael G.; Mummaneni, Praveen V.; Matz, Paul G.; Anderson, Paul A.; Groff, Michael W.; Heary, Robert F.; Holly, Langston T.; Ryken, Timothy C.; Choudhri, Tanvir F.; Vresilovic, Edward J.; Resnick, Daniel K.

In: Journal of Neurosurgery: Spine, Vol. 11, No. 2, 01.08.2009, p. 228-237.

Research output: Contribution to journalReview article

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T1 - Management of anterior cervical pseudarthrosis

AU - Kaiser, Michael G.

AU - Mummaneni, Praveen V.

AU - Matz, Paul G.

AU - Anderson, Paul A.

AU - Groff, Michael W.

AU - Heary, Robert F.

AU - Holly, Langston T.

AU - Ryken, Timothy C.

AU - Choudhri, Tanvir F.

AU - Vresilovic, Edward J.

AU - Resnick, Daniel K.

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N2 - Object. The objective of this systematic review was to use evidence-based medicine to identify the best methodology for diagnosis and treatment of anterior pseudarthrosis. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to pseudarthrosis and cervical spine surgery. Abstracts were reviewed, after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Evaluation for pseudarthrosis is warranted, as there may be an association between clinical outcome and pseudarthrosis. The strength of this association cannot be accurately determined because of the variable incidence of symptomatic and asymptomatic pseudarthroses (Class III). Revision of a symptomatic pseudarthrosis may be considered because arthrodesis is associated with improved clinical outcome (Class III). Both posterior and anterior approaches have proven successful for surgical correction of an anterior pseudarthrosis. Posterior approaches may be associated with higher fusion rates following repair of an anterior pseudarthrosis (Class III). Conclusions. If suspected, pseudarthrosis should be investigated because there may be an association between arthrodesis and outcome. However, the strength of this association cannot be accurately determined. Anterior and posterior approaches have been successful.

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Kaiser MG, Mummaneni PV, Matz PG, Anderson PA, Groff MW, Heary RF et al. Management of anterior cervical pseudarthrosis. Journal of Neurosurgery: Spine. 2009 Aug 1;11(2):228-237. https://doi.org/10.3171/2009.2.SPINE08729