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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 – Lumbar Fusion

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The article is a retrospective study comparing the outcomes and complications of two different techniques – the traditional two-rod construct and the four-rod construct – in patients with adult spinal deformity who underwent pedicle subtraction osteotomy. The study included 208 patients from two centers, and the clinicoradiological outcomes and complication profiles were statistically compared between the two groups. The results showed that the four-rod construct was associated with lower rates of rod fracture, pedicular screw loosening, and reoperation. Additionally, the four-rod technique led to a higher degree of lumbar lordosis correction and improved pelvic tilt and sacral vertical axis corrections. Overall, the four-rod construct was associated with improved quality of life and disability index, as well as lower complication profiles

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: Our results showed that the four-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 two-rod technique. The four-rod technique was also associated with improved quality of life and disability index and lower complication profiles.

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World Neurosurg. 2023 Dec 28:S1878-8750(23)01869-7. doi: 10.1016/j.wneu.2023.12.137. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective study OBJECTIVE: To compare clinicoradiological outcomes and complication profiles of the traditional two-rod construct versus the four-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 who underwent,

World Neurosurg. 2023 Dec 28:S1878-8750(23)01869-7. doi: 10.1016/j.wneu.2023.12.137. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective study OBJECTIVE: To compare clinicoradiological outcomes and complication profiles of the traditional two-rod construct versus the four-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 who underwent lumbar PSO and long fusion from thoracic to the pelvis at two centers. Two different techniques including the four-rod construct and the traditional two-rod technique were used at the PSO level. Clinicoradiological outcomes and complication profiles of the patients were documented and compared statistically between the groups.

RESULTS: The four-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 four-rod technique 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 four-rod construct was associated with improved quality of life (p=0.04) and statistically lower oswestry disability index at 12 months postoperatively (p<0.01).

S: Our results showed that the four-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 two-rod technique. The four-rod technique was also associated with improved quality of life and disability index and lower complication profiles.

PMID:38159604 | DOI:10.1016/j.wneu.2023.12.137

The London Spine Unit : best recognised day surgery spinal centre in the world

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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

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World Neurosurg. 2023 Dec 28:S1878-8750(23)01869-7. doi: 10.1016/j.wneu.2023.12.137. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective study OBJECTIVE: To compare clinicoradiological outcomes and complication profiles of the traditional two-rod construct versus the four-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 who underwent
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