PreprintArticleVersion 1This version is not peer-reviewed
Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra
Version 1
: Received: 13 September 2024 / Approved: 13 September 2024 / Online: 13 September 2024 (11:51:32 CEST)
How to cite:
Lee, K. Y.; Lee, J.-H.; Han, G.; Jung, C.-H.; Park, H. S. Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra. Preprints2024, 2024091084. https://doi.org/10.20944/preprints202409.1084.v1
Lee, K. Y.; Lee, J.-H.; Han, G.; Jung, C.-H.; Park, H. S. Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra. Preprints 2024, 2024091084. https://doi.org/10.20944/preprints202409.1084.v1
Lee, K. Y.; Lee, J.-H.; Han, G.; Jung, C.-H.; Park, H. S. Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra. Preprints2024, 2024091084. https://doi.org/10.20944/preprints202409.1084.v1
APA Style
Lee, K. Y., Lee, J. H., Han, G., Jung, C. H., & Park, H. S. (2024). Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra. Preprints. https://doi.org/10.20944/preprints202409.1084.v1
Chicago/Turabian Style
Lee, K. Y., Cheol-Hyun Jung and Hong Sik Park. 2024 "Revision Methods for Rod Fracture after Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Comparative Analysis between Simple Rod Replacement, Lateral Lumbar Interbody Fusion around Pedicle Subtraction Osteotomy Site, and Accessory Rod Integra" Preprints. https://doi.org/10.20944/preprints202409.1084.v1
Abstract
Background: Rod fracture (RF) is the most common cause of revision in adult spinal deformity (ASD) surgery, and various treatment strategies for preventing RF are reported in literature. This retrospective study involving 139 ASD patients (aged ≥65 years and a minimum 2-year follow-up) who underwent long-segment fixation from T10 to sacrum with pedicle subtraction osteotomy (PSO), analyzed long-term results, including radiographical parameters and the incidence of recurrent RF (re-RF), to determine the most effective revision method for preventing RF. Methods: Patients were classified into three groups according to the revision method performed for RF; simple rod replacement (SR group, n=17), lateral lumbar interbody fusion around PSO site (LLIF group, n=8), and accessory rod integration (AR group, n=22). Baseline characteristics, radiographical and clinical parameters were analyzed. Results: RF occurred in 47 patients (34%) at an average of 28 months following primary deformity correction. Re-RF occurred in six patients (13%) at an average of 37 months. Re-RF occurred most commonly in SR group (p=.048). Every re-RF in SR group occurred at the PSO site, none occurred in LLIF group, and one in AR group occurred near L4–5. After both primary deformity correction and revision surgery, spinopelvic parameters had shown favorable results and clinical outcomes had improved in all three groups, without significant intergroup differences. Conclusions: Accessory rod integration or additional LLIF around the PSO site seems to provide greater strength and stability to the previously fused segments than simple rod replacement, which demonstrates the need for additional support in revision surgery for RF after PSO.
Medicine and Pharmacology, Orthopedics and Sports Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
