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Semin Plast Surg 2021; 35(01): 020-024
DOI: 10.1055/s-0041-1723832
Review Article

Failures in Thoracic Spinal Fusions and Their Management

Marc Prablek
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
John McGinnis
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
Sebastian J. Winocour
2   Department of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Edward M. Reece
2   Department of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Udaya K. Kakarla
3   Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
,
Michael Raber
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
Alexander E. Ropper
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
David S. Xu
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Abstract

Instrumented fixation and fusion of the thoracic spine present distinct challenges and complications including pseudarthrosis and junctional kyphosis. When complications arise, morbidity to the patient can be significant, involving neurologic injury, failure of instrumentation constructs, as well as iatrogenic spinal deformity. Causes of fusion failure are multifactorial, and incompletely understood. Most likely, a diverse set of biomechanical and biologic factors are at the heart of failures. Revision surgery for thoracic fusion failures is complex and often requires revision or extension of instrumentation, and frequently necessitates complex soft tissue manipulation to manage index level injury or to augment the changes of fusion.

Keywords

thoracic spinal fusion - pedicle screw fixation - proximal junctional kyphosis - proximal junctional failure - pseudarthrosis


Publication History

Article published online:
10 May 2021

© 2021. Thieme. All rights reserved.

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