Thoracolumbar pseudarthrosis.

Pseudarthrosis is the leading cause of failed spine fusion and is of paramount concern to surgeons attempting fusion procedures. Thus, it is essential to understand this complication to direct efficient and intelligent management. A review of various modalities in the identification and diagnosis of a pseudarthrosis is presented. In addition, its histologic features and classification system are discussed. Not all pseudarthroses need treatment. When treatment is considered, however, there are both nonoperative and operative strategies. Operative alternatives include posterolateral, anterior, or anterior-posterior combined fusions.