Material removal after anterio-posterior spondylodesis -- necessity of posterior instrumentation removal after osseous fusion

• Published in: Zentralblatt für Chirurgie Vol. 130; no. 4; p. 297
• Main Authors: Linhardt, O, Refior, H J, Krödel, A
• Format: Journal Article
• Language: German
• Published: Germany 01.08.2005
• Subjects: Adult; Aged; Bone Transplantation; Debridement; Device Removal; Female; Follow-Up Studies; Humans; Intraoperative Complications; Male; Middle Aged; Postoperative Complications; Prospective Studies; Spinal Fusion - instrumentation; Spinal Fusion - methods; Spondylitis - surgery; Time Factors; Treatment Outcome; Wound Healing
• ISSN: 0044-409X
• DOI: 10.1055/s-2005-836782

The present study on spondylitis patients with anterio-posterior spondylodesis was carried out to get a recommendation whether material removal is necessary after osseous fusion. A total of 12 patients with spondylitis were operated on at the Orthopaedic Department of Ludwig-Maximilians-University Munich with posterior instrumentation after debridement and fusion with autologous bone transplant. In a prospective clinical investigation we examined our patients regarding clinical and radiological outcome preoperatively, 2 weeks, 12 months and 4.9 years after operation. We paid special attention on complications and loss of correction in leaving posterior instrumentation. Compared with the advanced clinical signs of spondylitis, minor intra- and postoperative complications were seen. Two patients showed superficial wound infections with fistulization because of the posterior implants 3 years postoperatively. Both cases closed after revision and material removal without complications. 12 months and 4.9 years postoperatively the average loss of correction was constant 2 degrees . Generally material removal of posterior spinal instruments results in a significant loss of correction in the spondylodesis segment. Our study shows, that persisting posterior instrumentation could prevent loss of correction. On the other hand we recommend material removal in case of spondylodesis after osseous fusion to prevent wound healing complications.