The Advantages of 4-rod Construct over the 2-rod Techniques in Adult Spinal Deformity Patients who Underwent Pedicle Subtraction Osteotomy: A Multicenter Retrospective Comparative Study.

Autor: Kankam SB; Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Zarei M; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Moghadam N; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran., Roohollahi F; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran., Moosavi M; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran., Yaseen Khan FM; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran., Besharaty S; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran., Abbaspour MJ; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran., Rostami M; Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: rostamim@sina.tums.ac.ir.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Mar; Vol. 183, pp. e530-e539. Date of Electronic Publication: 2023 Dec 29.
DOI: 10.1016/j.wneu.2023.12.137
Abstrakt: Objective: In this retrospective study we compared clinicoradiologic outcomes and complication profiles of the traditional 2-rod construct versus the 4-rod construct in patients with adult spinal deformity (ASD) who underwent pedicle subtraction osteotomy (PSO).
Methods: We performed a retrospective review of 208 ASD patients at 2 referral centers who underwent lumbar PSO and long fusion from thoracic to the pelvis. Two different techniques, including the 4-rod construct and the traditional 2-rod technique, were used at the PSO level. Clinicoradiologic outcomes and complication profiles of the patients were documented and compared statistically between the groups.
Results: The 4-rod construct was associated with statistically lower rates of rod fracture (44.8% vs. 26.4%, P < 0.01), pedicular screw loosening at the PSO level (25.3% vs. 14.0%, P = 0.04), and reoperation (49.4% vs. 33.9%, P = 0.02). Radiologically, the 4-rod construct was associated with higher degree of lumbar lordosis (LL) (-37.4°vs. -26.8°; P < 0.01) and improved pelvic tilt (PT) (-17.2° vs. -9.9°; P < 0.01) and sacral vertical axis (SVA) corrections (-211.5° vs. -192.2°; P = 0.04). Overall, the 4-rod construct was associated with improved quality of life (P = 0.04) and statistically lower Oswestry Disability Index score at 12 months postoperatively (P < 0.01).
Conclusions: Our results showed that the 4-rod construct was associated with statistically lower rates of rod fracture and pedicular screw loosening at the osteotomy level, higher degree of LL correction and improved PT and SVA than the 2-rod technique. The 4-rod construct was also associated with improved quality of life and Oswestry Disability Index and lower complication profiles.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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