F-Naf PET/CT in pseudarthrosis after anterior cervical discectomy and fusion.

Background Context: Pseudarthrosis is a well-known cause of persistent or recurrent pain after anterior cervical discectomy and fusion (ACDF). Numerous radiographic criteria to determine the fusion status has been described in the literature, but their accuracies in clinical practice vary considerably and no 1 single method has proved superior. Fluorine-18 sodium fluoride (F-NaF) positron emission tomography/computed tomography (PET/CT), depicting osteoblastic activity, might be useful to identify pseudarthrosis after ACDF.

Value of F-FDG PET/CT to Identify Occult Infection in Presumed Aseptic Pseudarthrosis after Spinal Fusion: Correlation with Intraoperative Cultures.

 Fluorine-18 fluorodeoxyglucose ( F-FDG) positron emission tomography/computed tomography (PET/CT) has gained attention as an emerging tool in case of suspicion of infection on spine, whether native or instrumented. However, the diagnostic performance of F-FDG PET/CT in clinically occult low-grade surgical site infection (SSI) after spinal fusion, an important risk factor for pseudarthrosis, remains unknown.  We retrospectively identified all the presumed aseptic patients with pseudarthrosis confirmed by revision surgery who underwent preoperative F-FDG PET/CT scans performed between April 2019 and November 2022.

F-NaF PET/CT in Presumed Aseptic Pseudarthrosis after Spinal Fusion: Correlation with Findings at Revision Surgery and Intraoperative Cultures.

 Conventional imaging is useful to assess interbody fusion by showing complete trabecular bony bridging, but has a low positive predictive value for pseudarthrosis. Because alterations of bone metabolism may precede structural anatomical changes on computed tomography (CT), we aimed to investigate the ability of fluorine 18 sodium fluoride positron emission tomography/computed tomography ( F-NaF PET/CT) to identify pseudarthrosis after spinal fusion using surgical revision as the reference standard.  We retrospectively reviewed F-NaF PET/CT scans performed between February 2019 and September 2020 in patients experiencing pain after spinal fusion.

Clinical and radiological outcomes of a cervical cage with integrated fixation.

Cervical cages with integrated fixation have been increasingly used in anterior cervical discectomy and fusion (ACDF) to avoid complications associated with anterior cervical plates. The purpose of this paper is to provide 2-year follow-up results of a prospective study after implantation of a cervical cage with an integrated fixation system.This was a prospective multicenter outcome study of 90 patients who underwent ACDF with a cage with integrated fixation.