Review
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World J Radiol. May 28, 2012; 4(5): 193-207
Published online May 28, 2012. doi: 10.4329/wjr.v4.i5.193
Spinal fusion-hardware construct: Basic concepts and imaging review
Mohamed Ragab Nouh
Mohamed Ragab Nouh, Department of Radiodiagnosis and Clinical Imaging, Faculty of Medicine, Alexandria University, Alexandria 21599, Egypt
Mohamed Ragab Nouh, Department of Radiology, Al-Razi Hospital, Sulibikhate 13001, Kuwait
Author contributions: Nouh MR selected the subject, reviewed the literature, wrote the paper, selected the figures and edited the whole work.
Correspondence to: Mohamed Ragab Nouh, MD, Radiology Specialist, Department of Radiology, Al-Razi Hospital, Jamal Abdulnaser street, Sulibikhate 13001, Kuwait. mragab73@yahoo.com
Telephone: +965-24825508 Fax: +965-24825909
Received: June 1, 2011
Revised: August 7, 2011
Accepted: August 14, 2011
Published online: May 28, 2012
Abstract

The interpretation of spinal images fixed with metallic hardware forms an increasing bulk of daily practice in a busy imaging department. Radiologists are required to be familiar with the instrumentation and operative options used in spinal fixation and fusion procedures, especially in his or her institute. This is critical in evaluating the position of implants and potential complications associated with the operative approaches and spinal fixation devices used. Thus, the radiologist can play an important role in patient care and outcome. This review outlines the advantages and disadvantages of commonly used imaging methods and reports on the best yield for each modality and how to overcome the problematic issues associated with the presence of metallic hardware during imaging. Baseline radiographs are essential as they are the baseline point for evaluation of future studies should patients develop symptoms suggesting possible complications. They may justify further imaging workup with computed tomography, magnetic resonance and/or nuclear medicine studies as the evaluation of a patient with a spinal implant involves a multi-modality approach. This review describes imaging features of potential complications associated with spinal fusion surgery as well as the instrumentation used. This basic knowledge aims to help radiologists approach everyday practice in clinical imaging.

Keywords: Hardware; Imaging; Instrumentation; Spinal fusion; Spine