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28.01.2020 | Original Article

Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis

verfasst von: Fernando Guevara-Villazón, Louis Boissiere, Kazunori Hayashi, Daniel Larrieu, Soufiane Ghailane, Jean-Marc Vital, Olivier Gille, Vincent Pointillart, Ibrahim Obeid, Anouar Bourghli

Erschienen in: European Spine Journal | Ausgabe 4/2020

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Abstract

Purpose

Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.

Methods

This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up. Matching was considered with demographical data, preoperative radiographical parameters, preoperative clinical status [health-related quality-of-life (HRQoL) scores] and surgical characteristics (anterior fusion, decompression, rod material, osteotomies). Postoperative radiographical and clinical parameters, as well as complications, were obtained. Univariate and multivariate analysis was performed regarding postoperative improvement, group variables comparison and parameters correlation.

Results

Thirty-three patients with multi-rod construct and 33 matched with a two-rod construct were selected from a database with 346 ASD-operated patients. Both groups had a significant improvement with surgical management in the radiographical and HRQoL parameters (p < 0.001). Differences between groups for the postoperative radiographical, clinical and perioperative parameters were not significant. Rod breakage was more frequent in the two-rod group (8 vs 4, p = 0.089), as well as the respective revision surgery for those cases (6 vs 1 p = 0.046). Risk factors related to revision surgery were greater kyphosis correction (p = 0.001), longer instrumentation (p = 0.037) and greater sagittal vertical axis correction (p = 0.049).

Conclusion

No major disadvantage on the use of multi-rod construct was identified. This supports the benefit of using multi-rod constructs to avoid implant failure.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Titel: Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis
verfasst von: Fernando Guevara-Villazón
Louis Boissiere
Kazunori Hayashi
Daniel Larrieu
Soufiane Ghailane
Jean-Marc Vital
Olivier Gille
Vincent Pointillart
Ibrahim Obeid
Anouar Bourghli
Publikationsdatum: 28.01.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 4/2020
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-020-06311-z

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Springer Medizin

Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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