A Cadaveric Study on Lumbar Spinous Process Fusion: Risk Factor for Wrong Level Spinal Surgeries

Introduction: The fusion of Lumbar Spinous Processes (LSP) of adjacent vertebrae may lead to errors in determining the correct spinal level. This may result in wrong level spinal surgeries around the lumbar region. Aim: To determine the prevalence of fusion between adjacent LSP. Materials and Methods: This study was a prospective observational study done in the Department of Anatomy, Smt. B.K. Shah Medical Institute and Research Centre, Vadodara, Gujarat, India. The present study had examined the lumbar spines in 30 formalin preserved cadavers. The fusion between the LSP of adjacent vertebrae was recorded after the removal of soft tissue from L1 to S1 vertebrae. Results: The present study found the fusion between the adjacent LSP in 11 (36.67%) cadavers (08 males; 03 females). The fusion between the adjacent LSP, from L4 to S1 vertebrae, was found in 10% of cadavers and was the most common pattern. The fusion between the adjacent LSP was more common in males (53.3%) compared to females (20%). Conclusion: The occurrence of fusion between the adjacent LSP is not uncommon.