A novel 4-rod technique offers potential to reduce rod breakage and pseudarthrosis in pedicle subtraction osteotomies for adult spinal deformity correction

Sachin Gupta, Murat Sakir Eksi, Christopher P. Ames, Vedat Deviren, Blythe Durbin-Johnson, Justin S. Smith, Munish C. Gupta

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

BACKGROUND: Pedicle subtraction osteotomy (PSO) can be used to treat rigid sagittal plane deformities. Nonunions and rod breakages are known complications of PSO. OBJECTIVE: To assess outcomes of 2methods of posterior instrumentation for PSO, traditional 2 rods vs a novel 4-rod technique inwhich 2 additional rods span only the osteotomy level. METHODS: This study was a retrospective, radiographic review of consecutive PSOs performed at 2 centers. The primary difference in technique between the centers was the use of 4 rods including 2 independent rods attached only to the vertebral levels immediately adjacent to thePSO(group 1, n=29 patients) vs the traditional 2-rod technique (group 2, n = 20 patients). RESULTS: Demographics and preoperative to postoperative radiographic measurements were similar between the study groups, including the PSO wedge resection angle (P=.56). The rod breakage rate was 25% with 2 rods and 0%with 4 rods (P=.008), and the pseudarthrosis rate with 2 rods was 25% and with 4 rods was 3.4% (P = .035). The patient with pseudarthrosis fromgroup 1 had an infection and developed pseudarthrosis only after instrumentation removal. Rates of other complications did not differ significantly between the study groups. CONCLUSION: This study provides a comparison between 2 techniques for rod placement across a PSO and suggests that the described novel 4-rod technique may help to reduce the rates of pseudarthrosis and rod failure. It will be important to confirm these findings in a prospectively designed study with multiple institutions in order to better control for potentially confounding factors.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalOperative Neurosurgery
Volume14
Issue number4
DOIs
StatePublished - Apr 1 2018

Keywords

  • 4-rod technique
  • Complications
  • Deformity
  • Fusion
  • Pedicle subtraction osteotomy
  • Pseudarthrosis

Fingerprint Dive into the research topics of 'A novel 4-rod technique offers potential to reduce rod breakage and pseudarthrosis in pedicle subtraction osteotomies for adult spinal deformity correction'. Together they form a unique fingerprint.

  • Cite this