The Role of Bone Scintigraphy in Determining Spinal Fusion after Spinal Stabilisation Surgery

To evaluate the usefulness of bone scintigraphy in spinal fusion surgery.

This retrospective study included 21 patients who had undergone previous anterior or posterior spinal fusion procedures, or both. Implant failure, fusion failure and adjacent segment disease were the evaluated pathological parameters. Scintigraphic data from all patients were evaluated with intraoperative observational data, radiological data and clinical data.

Radiological evaluation revealed adjacent segment disease in 5 patients (23.8%), implant failure in 2 (9.5%), and fusion failure in 1 (4.8%). Scintigraphic evaluation of operating segments revealed pseudo-fusion in 3 patients (14.3%) and fusions in 18 (85.7%). Reoperations were performed in 9 patients (42.9%): in 5 (23.8%) because of adjacent segment disease, and in 4 (19.0%) because they requested removal of the implants. Two patients (9.5%) with implant failure did not undergo reoperation because their scintigraphic data were consistent with fusion and they were almost symptom free, with lower Visual Analogue Scale (VAS) scores. The VAS scores of the rest of the patients were significantly reduced after the reoperations (p < 0.001).

Bone scintigraphy may be helpful for surgeons in planning appropriate surgical revision strategy by giving proper data about spinal fusion at least one year after the initial surgery.