ABSTRACT
Reconstructive surgery for thoracolumbar deformity can be fraught with complications, one of which is pseudarthrosis or nonunion. The decision to pursue surgery requires a thoughtful and extensive discussion in which the amount of discomfort and disability caused by the nonunion is weighed against the risks of a major spinal revision operation. Surgical intervention for a thoracolumbar pseudarthrosis can be considered a complex spinal revision operation, and the decision to operate must be carefully considered. Given the fact that repair of a nonunion is a complex revision operation with manipulation of spinal implants, the existence of a systemic or local infection can be considered a relative contraindication. Other postoperative considerations involve prevention of thromboembolism via early mobilization, sequential compression devices, and chemoprophylaxis. Systemic medical complications such as cardiopulmonary events, thromboembolism, hospital delirium, systemic infections, and ileus occur after the operations in similar frequency to any complex thoracolumbar spinal reconstruction.
