McMaster University Department of Surgery, Division of Orthopaedics, Hamilton Health Sciences - General Site, 6 North Trauma, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2.
Injury. 2011 Mar;42(3):306-13. doi: 10.1016/j.injury.2010.11.041. Epub 2010 Dec 13.
The ability to correctly diagnose spinal non-union is vital to our ability to diagnose and treat patients with new or recurrent symptoms following spine fusion and to accurately assess the efficacy of spine fusion techniques and technologies. Surgical exploration has traditionally been the gold-standard investigation for spinal non-union. As routine surgical exploration is impractical in the majority of patients the use of non-invasive radiologic methods of spine fusion assessment is necessary. The purpose of this paper is to outline the most common radiologic methods of spine fusion assessment including the strengths and limitations associated with each imaging modality. In addition we will review the best-available evidence for the use of radiologic investigations to diagnose spine non-unions. We will then provide recommendations for what we believe to be the best methods of diagnosing successful union of cervical interbody, lumbar interbody and lumbar posterolateral fusions that can be used by spine clinicians and researchers alike.
正确诊断脊柱骨不连对于我们诊断和治疗脊柱融合术后出现新的或复发症状的患者的能力至关重要，也有助于准确评估脊柱融合技术的疗效。手术探查一直是脊柱骨不连的金标准检查方法。由于在大多数患者中常规手术探查不切实际，因此需要使用非侵入性的脊柱融合评估放射学方法。本文旨在概述最常见的脊柱融合评估放射学方法，包括每种成像方式的优缺点。此外，我们还将回顾使用放射学检查诊断脊柱骨不连的最佳证据。然后，我们将针对脊柱临床医生和研究人员提出我们认为诊断颈椎椎间融合、腰椎椎间融合和腰椎后外侧融合成功融合的最佳方法的建议。
