The management of pseudarthrosis following lumbar fusion continues to be controversial. The authors reviewed 43 procedures. Posterolateral fusion using a variety of implants was performed in 38 cases and anterior fusion was performed in six. Significantly improved results were seen in patients in whom a solid fusion was obtained, who had undergone only one prior lumbar spine surgery, and in whom the initial indication for fusion had been spondylolisthesis.
Patient selection is essential in achieving acceptable results.