Imaging of spinal fusion

Surgical spinal fusion is a procedure where two or more of the vertebrae of the spine are “fused” together in an attempt to achieve solid arthrodesis and to potentially eliminate painful movement or to correct deformity. The purpose of the spinal hardware is to provide additional spinal stability while helping the fusion set up. The first successful surgical fusion procedures were described by Hibbs in 1911 for prevention of progressive deformity from Pott disease. Spinal fusion surgeries have increased markedly in frequency in recent decades. In fact, according to a report by the Agency for Healthcare Research and Quality (AHRQ), there has been growth of 70 per cent from 2001. Spinal fusion is an accepted management for spinal instability secondary to trauma, infection, tumour, congenital anomalies such as scoliosis and for progressive spinal deformity. The purpose of this review is to highlight the basic concepts of surgical spinal fusion and to consider the most common radiological methods of spinal fusion assessment including their strengths and limitations at demonstrating postsurgical complications.