Neurospine.  2021 Dec;18(4):816-823. 10.14245/ns.2142596.298.

Multiple-Rod Constructs Do Not Reduce Pseudarthrosis and Rod Fracture After Pedicle Subtraction Osteotomy for Adult Spinal Deformity Correction but Improve Quality of Life

Affiliations
  • 1Orthopedic and Spinal Surgery Department, Kingdom Hospital, Riyadh, Saudi Arabia
  • 2Clinique du Dos, Elsan Jean Villar Private hospital, Bordeaux, France
  • 3Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch School of Medicine, Dunedin, New Zealand
  • 4Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain
  • 5Spine Surgery Unit, Acibadem Maslak Hospital, Istanbul, Turkey
  • 6Spine Surgery Unit, Hospital Universitario Val Hebron, Barcelona, Spain
  • 7Spine Center, Schulthess Klinik, Zurich, Switzerland

Abstract


Objective
To compare the radiological and functional outcomes and complications of adult spinal deformity patients who underwent a pedicle subtraction osteotomy (PSO) below L2 but categorized according to their construct where either 2-rod or multiple-rod construct is applied.
Methods
Sixty-seven patients met the inclusion criteria, and were categorized into 3 groups: 2 rods (2R), multiple rods around the PSO (MRP), multiple rods around the PSO and lumbosacral junction (MRL). Demographic data, operative parameters, spinopelvic parameters, functional outcomes, and complications were collected.
Results
Health-related quality of life scores showed a better outcome at 6 months and last follow-up visits in the MRP and MRL groups which were noted on different domains of Scoliosis Research Society-22 questionnaire, 36-item Short Form Health Surve, and Oswestry Disability Index scores (p < 0.05). The 3 groups showed similar rates of rod-related complications with no significant difference (p = 0.95). And inside each group, distribution of complications between pseudarthrosis with revision and rod fracture without revision was also similar (p = 0.99).
Conclusion
The use of multiple rods across the PSO did not show a better outcome when compared to single rods in terms of incidence and types of mechanical complications. However, better postoperative coronal alignment and health-related quality of life scores in the multiple rods group could be seen demonstrating an improved functional outcome.

Keyword

Adult spine deformity; Pedicle subtraction osteotomy; Multiple-rod construct; Rod fracture; Pseudarthrosis; Revision
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