CT Not Ideal to Assess Spinal Fusion Post Lumbar Arthrodesis

Modest fusion prediction and sensitivity with decreasing lumbar spine slice thickness, spacing

THURSDAY, Aug. 11 (HealthDay News) -- Computed tomography (CT) proves to be less than ideal to assess the extent of bony fusion after attempted lumbar arthrodesis, according to a study published in the July issue of The Spine Journal.

Jessica M. Ho, Ph.D., from the Baylor College of Medicine in Houston, and colleagues assessed a series of CT scans to ascertain the optimal parameters for determining fusion status versus pseudarthosis after attempted lumbar fusion. Each CT assessment was done using one of six predefined sets of parameters. Human cadaveric spine specimen with a T10 to S1 thoracolumbar posterolateral fusion augmented by instrumentation and anterior lumbar interbody fusions was used as a gold standard for comparison.

The investigators found that the predictive values and sensitivity improved modestly with decreasing slice thickness and slice spacing. The negative predictive value (NPV) for all sets of parameters was higher than the positive predictive value (PPV). The highest NPV and PPV were seen for CT parameters of 0.9-mm thick sections with 50 percent overlap, and were 90 and 59, respectively.

"In this study, the thinnest slice CT examinations were marginally better than thicker sections, and inaccuracies in fusion assessments occurred with all scan parameters that were studied," the authors write.

Several of the study authors disclosed financial ties to the medical device industry.

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Physician’s Briefing Staff

Physician’s Briefing Staff

Published on August 11, 2011

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