What is pseudoarthrosis of the cervical and lumbar spine?
Pseudoarthrosis of the cervical and lumbar spine
Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:
Issues with the instruments used to stabilize the bone
Lack of bone growth
The number of vertebrae being fused.
The patient’s health and lifestyle play a role in failed fusions, which can include
Diabetes
Inflammatory health conditions increase the risk
Smoking
Long-term steroid use
In many cases, revision surgery is needed.
Surgery-Related
During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:
Plates
Rods
Screws
The bone graft promotes growth between the two bones.
The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
The hardware goes inside, or internal fixation.
Although rare, a severe spinal fracture or deformity may need external fixation.
A rigid frame secured outside the body helps to stabilize the bones.
If the fusion fails, it could be caused by one or more of the following surgical issues:
The surgeon must carefully plan and use the right hardware.
The type of hardware used during a spinal fusion may influence bone healing.
The instruments can come loose or break, interfering with the fusion process.
Spinal osteoporosis, having thin, weak bones, can affect fixation.
Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.
Bone Graft
The type of bone graft used may affect the fusion.
For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.
Risk Factors
The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)
The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
Rarely does a pinched nerve affect both arms.
The pain may return shortly after the procedure.
The pain may develop gradually or not appear for many months.
However, it’s more likely to appear after several months when the individual returns to their usual activities.
Diagnosis
The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
They’ll assess mobility and the type of movement that causes pain.
Then, they order diagnostic imaging to see the spine and identify the cause of pain.
Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.
Treatment
Treatment for pseudoarthrosis will likely start with:
Physical therapy
Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
Medication
Injections
If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Enhancing Health Together
References
Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. https://doi.org/10.1186/s12891-024-07531-w
Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. https://doi.org/10.1055/s-0041-1722853
Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. https://doi.org/10.14444/4029
Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1
Scoliosis Research Society. (2023). Pseudoarthrosis. https://www.srs.org/Patients/Conditions/Pseudoarthrosis
Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. https://doi.org/10.1007/s11914-023-00824-4
Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. https://doi.org/10.1007/s11914-015-0286-8
Alexander Jimenez grew up knowing he was going to be a chiropractic doctor. As a child, Dr. Jimenez’s grandmother (Rebecca Tinoco of Bogota, Columbia)� experienced pain symptoms and would ask little Alex to massage the painful areas. His grandmother found relief and Dr. Jimenez began to think about how he could help others experiencing pain. �
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It was through this care that Dr. Jimenz realized being a health care chiropractic practitioner was the best way to help people. Like his grandfather, many others have experienced profound results thanks to chiropractic treatment. Dr. Jimenez knew that he wanted to be able to treat patients naturally. He would learn and develop the skills required to practice as a chiropractic physician. He enrolled in a university chiropractic program, graduated, has put in almost 30 years of work, and the rest is history. What to know about chiropractic physicians.
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A Chiropractic Physician*
A Doctor of Chiropractic also known as a D.C. is far more than a back doctor. Chiropractors study the same sciences as doctors of medicine or MDs. They are trained in the latest techniques and approaches, diagnostic tools, and developing effective treatment plans to manage various health conditions. However, chiropractic physicians specialize in non-invasive/non-surgical/non-pharmacological health care protocols and focus on whole-body health and natural healing. Wide range of factors that can impact an individual�s health like:
Biomechanical dysfunction
Diet
Genetics
Trauma
Hygiene
Emotions
Environment – Home/work
Infection/s
Lack of exercise
Posture
Stress levels
Based on these factors a chiropractor is able to determine the most effective, beneficial natural treatment plan.
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Work
Chiropractic physicians encourage individuals to look at natural, medication/surgery-free approaches to improve health, reduce, and alleviate painful symptoms. They are often called upon for preventive and rehabilitative health care. �
� Chiropractic treatment is responsible for thousands of back surgeries being avoided, as well as injuries being prevented with conservative care. Chiropractors perform manual, and tool-assisted adjustments of the spine and the body’s other joints. Depending on their training, they could practice:
Acupuncture
Functional medicine
Nutritional medicine
Physical rehabilitation
Provide supplements like vitamins and natural botanicals
Chiropractors utilize diagnostic tests like X-rays, ultrasound, and check blood pressure. They can order and interpret blood samples, urine samples, and other medical lab tests. Chiropractic physicians are able to:
Practice as primary-care physicians in most states
Doctors of chiropractic are able to treat individuals of all ages, and a variety of health conditions. Most know about chiropractors and their expertise in treating back pain, neck pain, and headaches. However, chiropractors can also treat many types of injuries and disorders involving the musculoskeletal system. They can:
Release tight muscles
Stretch out ligaments
Return joint mobility
Relieve overuse/repetitive injuries
Ease migraines
Rehabilitate/Prevent sports injuries
Treat automobile accident injuries
Reduce/Alleviate arthritis
The Most Effective Chiropractor
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Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
NOTICE: The Texas Board of Chiropractic and The Texas Supreme Court defines a Chiropractor as a Doctor. New Mexico State Bylaws and New Mexico Chiropractic State Board define a Chiropractor as a Chiropractic Physician*.
Both are the same however the bylaws require legal and literal defining.�
If you’re the kind of person who values optimal health, or simply if you don’t feel good and you wish to find the cause of the problem of while not being dependent on drugs and preventing chronic disease instead of just treating the symptoms, functional medicine is a perfect match for you.
What are functional medicine practitioners?
Functional medicine practitioners or doctors are trained to find the cause of medical issues. Functional medicine uses an in depth history as well as state of the art, cutting edge, innovative testing, along with an in depth understanding of human physiology, to uncover what has gone wrong in the individual’s body.
A functional medicine practitioner may be physician of any discipline. It is possible to find Naturopathic, Medical, Osteopathic and Chiropractic functional medicine doctors. These doctors are the type who aren’t happy with conventional treatment methods used to treat injuries or other types of conditions. Functional medicine doctors possess a passion to find the origin of the patients’ disease to provide overall health and wellness.
Understanding Functional Medicine
Functional medicine is a specialty which requires an unbelievable amount of advanced training. These doctors need to have a firm grasp on the basics of anatomy, biochemistry. Ongoing training is necessary to keep up with the ever-advancing testing. Instead of prescribing drugs for symptoms, these doctors work to get their patients well by repairing and discovering the cause of the issue.
Certified functional medicine training is available to physicians of all disciplines. A certified medication doctor must first pass a series of examinations and must complete about 200 hours of functional medicine training. Licensed functional medication doctors are current on the newest testing and therapy procedures. It you have a choice, get good care of a certified medicine practitioner to receive the best form of care and treatment.
Functional medicine treatment can be essential when treating a common problem like diabetes. When a patient goes to a standard physician, at best, they are given lifestyle and diet education and medication. Together with the disease every case of diabetes is treated exactly the same. The dilemma is that no two people are exactly the same. If everyone is different shouldn’t the treatment be unique for each individual?
After a comprehensive medical history of a patient with diabetes, for example, a testing strategy to figure out what was wrong and how to repair it so this patient could get well may be performed by the functional medicine practitioner. Doctors may often have to check just about every bodily fluid for a broad array of problems.
Functional medicine practitioner or doctors can help patients replenish their body together with the things it is deficient in and rid his body of toxins. How do you believe these health problems would have responded to the standard disease based therapy strategy of a prescription medicine? Drugs do not tackle toxicities and deficiencies, and too often they add toxicity and side effects that are unpleasant as well.
The biggest objection to functional medication is that insurance does not cover a lot of the treatment or testing. It’s true that functional medicine doctors can sometimes cost you more in the start. However, the standard medical approach is more costly in the end. Consider a patient in the setting of the above example. What happens to their kidneys or heart with medical therapy. How expensive is a heart attack, stroke, kidney dialysis or substitute, cancer, or Crohn’s disease?Healthcare specialists know it is always better and cheaper to correct a problem early on, and the sooner the better.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
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