Spine Surgery pp 641-647 | Cite as

Management of Pseudarthrosis with Implant Failure

  • Christoph FleegeEmail author


The risk factors listed above, have an influence on the rate of fusion in lumbar spinal surgery. Therefore, a special preoperative assessment of the risks should be performed. In addition to an optimal performed surgical technique with careful dissection of the intervertebral disc space and impaction of autologous bone or bone substitute material, the use of BMP, the administration of vitamin D supplements, improved diabetes adjustment, can increase bone fusion and reduce revisions. In cases with proven non-union and/or implant failure, careful revision is required from posterior and anterior. Important are stable situations and no complete stress shielding due to Wolff’s law to support a bony healing in the intervertebral disc space. Due to the variety of diseases and the inadequate study situation with low cases at the field of cage materials and fusion technique, evidence-based therapy recommendations are difficult to give.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Spine DepartmentOrthopaedic University Hospital FriedrichsheimFrankfurtGermany

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