Long additional rod constructs can reduce the incidence of rod fractures following 3-column osteotomy with pelvic fixation in short term.

Abstract

A retrospective analysis of a prospectively collected consecutive case series of patients with adult spinal deformity who underwent 3-column osteotomy (3-CO) with pelvic fixation. The objectives were to verify the effect of additional rods and determine the optimal type of additional rod for preventing rod fracture (RF). RF is a frequent complication following 3-CO surgery in patients with adult spinal deformity. Two types of additional rod constructs were utilized to prevent RF. We evaluated data retrieved from a prospectively collected single-center database. Patients were classified into two groups depending on rod constructs: conventional 2-rod and 2-rod constructs with additional rods. The additional rod constructs were also stratified into two groups according to the location that they covered: only osteotomy site (short additional rod) or osteotomy site and lumbosacral junction (long additional rod). A total of 48 patients (average age 67.6 years; follow-up rate: 90.6%; 2-rod: 25 cases and additional rod: 23 cases) were included. No significant difference was observed in age, fusion level, operation time, blood loss, and rod composition. The incidence of RF in the additional rods (36%) was significantly lower than that in the 2-rod constructs (68%). Comparing the additional rod constructs, RF occurred in 7 cases (64%) in short additional rod and 2 cases (17%) in long additional rod. RF occurred at the level below the additional rod construct in 6 of 7 RF cases with short additional rod. Additional rods covering the osteotomy site and lumbosacral junction reduced the incidence of RF following 3-CO surgery with pelvic fixation in short term. 3.