Question 2762
{"accessible":false,"alternatives":[{"id":13482,"text":"fracture through the implant itself"},{"id":13484,"text":"lucency of bone around the implant screws"},{"id":13485,"text":"pseudoarthrosis of the adjacent endplates at the operative level"},{"id":13483,"text":"subsidence of the interbody graft 2 mm through the superior endplate"},{"id":13486,"text":"vacuum cleft in the treated disc space"}],"archived":false,"correctAlternativeId":13483,"explanation":"\u003cp\u003eInterbody grafts, especially stand-alone cages, may normally subside into the adjacent vertebral body by 3 mm or less before osseous fusion occurs. Therefore 2 mm of subsidence is not a sign of failure. \u003c/p\u003e\u003cp\u003eLack of fusion across a disc space is considered pseudoarthrosis, caused by persistent motion at the fused level and a vacuum cleft is often seen in this setting. This can be a significant cause of persistent or recurrent pain after surgery. Fracture of the implant itself and osseous lucency around the screws also indicate failure.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eReference:\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eGhodasara et al. Postoperative Spinal CT: What the Radiologist Needs to Know, Radiographics 2019\u003c/p\u003e","id":2762,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2776","nextQuestionPath":"/articles/spondylosis/questions/1344","relatedArticles":[{"id":91097,"title":"Complications of spinal surgery","link":"/articles/complications-of-spinal-surgery?lang=us"},{"id":91447,"title":"Spinal instrumentation hardware","link":"/articles/spinal-instrumentation-hardware?lang=us"},{"id":42153,"title":"Degenerated disc","link":"/articles/degenerated-disc-1?lang=us"}],"alsoUsedIn":[{"id":1734,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1734","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1734"},{"id":365,"kind":"LiveSchedule","title":"365","link":"https://radiopaedia.org/admin/live_schedules/365"},{"id":293,"kind":"LiveSchedule","title":"293","link":"https://radiopaedia.org/admin/live_schedules/293"},{"id":1500,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1500","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1500"},{"id":1500,"kind":"Course","title":"Musculoskeletal Lectures - page 1500","link":"https://radiopaedia.org/courses/musculoskeletal-lectures/pages/1500"}],"stem":"\u003cp\u003eWhich of the following is \u003cstrong\u003eNOT\u003c/strong\u003e a sign of failure of operative spinal fusion at one year after surgery?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2762"}],"attemptsPercentages":[{"alternativeId":"13483","percentage":53},{"alternativeId":"13484","percentage":8},{"alternativeId":"13486","percentage":26},{"alternativeId":"13485","percentage":10},{"alternativeId":"13482","percentage":3}],"promptToLogin":false,"questionManager":false,"articleId":"spondylosis"}