Pseudarthrosis, or non-union, is a fracture or fusion that has not healed in the time frame in which it should generally heal and has no chance of healing without further intervention.
Causes of pseudarthrosis can be related to the patient, fracture, or treatment. A patient’s age and nutritional status affect bone’s ability to heal. Infection, bone loss at the fracture site, damage of surrounding muscles, and improper treatment may also impede the healing process.
Although some patients may have no symptoms, many patients with lumbar pseudarthrosis present with back and/or leg pain, while many with cervical pseudarthrosis present with neck and/or arm pain. Imaging studies may be used to diagnose a non-union however these studies are not always reliable. A surgeon may need to rely on a second surgical procedure to confirm diagnosis on patients with painful, disabling symptoms.
Treatment of pseudarthrosis may include electrical stimulation to trigger the bone cells to form a structure that keeps bones from bending.
Bone graft may be applied to the fracture as a stimulus to bone healing. The graft may come from a bone donor or harvested from the patient undergoing surgery.
To stabilize the broken bone fragments, metal plates, screws, pins, and rods may be used.