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Master Thesis

Pseudarthrose du rachis dans la pathologie dégénérative : diagnostic et retentissement socio-professionnel

Abstract : Spine pseudarthrosis is one of the main long-term complications of cervical and lumbar fusion in degenerative pathology, which can affect the functional outcome. Its diagnosis is difficult and not consensual. We evaluate in 3 studies the diagnostic management and evolution of these patients. First, we conducted a retrospective multicenter study of 45 patients managed for pseudarthrosis after cervical spine fusion (1 or 2 levels) to evaluate the diagnosis value of the imaging tests performed. CT and dynamic X-ray appear to be the most relevant examinations for the diagnosis. We then conducted a single-centre retrospective study on 44 patients reoperated for pseudarthrosis after lumbar spine fusion (1 or 2 levels), evaluating the diagnosis value of the different imaging exams. 83.3% of the performed MRIs show a MODIC 1 signal of the involved level. CT appears to be the most sensitive examination. The median time to reintervention was 23.4 months. Finally, we conducted a single-center study on 36 patients treated for spinal pseudarthrosis (cervical or lumbar), via a phone survey on professional, social and sports life, ability to perform basic activities, and satisfaction with surgery. Only 46% of the cohort returned to work, there was no improvement in social and personal activities, and a large proportion of patients did not practice sports. The overall evolution is negative, surgery does not improve the life quality of the patients compared to the pre-operative period. Pseudarthrosis negatively affects the course of patients even after revision surgery. Reducing the time to revision by optimising diagnostic management and performing the most relevant examinations could improve the outcome of these patients.
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https://dumas.ccsd.cnrs.fr/dumas-03411725
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Submitted on : Tuesday, November 2, 2021 - 2:51:15 PM
Last modification on : Saturday, December 11, 2021 - 3:49:13 AM
Long-term archiving on: : Thursday, February 3, 2022 - 7:19:14 PM

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  • HAL Id : dumas-03411725, version 1

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Maxime Huneidi. Pseudarthrose du rachis dans la pathologie dégénérative : diagnostic et retentissement socio-professionnel. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03411725⟩

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