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
