ArticleSpine deformity2023
Rod fractures after multi-rod constructs in adult spinal deformity patients fused to the sacrum/pelvis: where do they occur and why?
Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Spinopelvic fixation failure in the adult spinal deformity population: systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Pooled it
- Comparison of complications, revisions, spinopelvic parameters, and health-related quality of life after posterior spinal fusion using multiple-rod constructs or two-rod constructs for adult spinal deformity: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- L1-pelvic angle: a convenient measurement to attain optimal deformity correction.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose(1) To describe the use of multi-rod constructs (MRCs) in adult spinal deformity (ASD) surgery, (2) to report rod fractures occurring at MRC sites, and (3) to evaluate risk factors for rod fractures.
methodsA single-center, retrospective cohort study was conducted of patients undergoing ASD surgery with these inclusion criteria: minimum 2-year follow-up, MRCs used, ≥ 10-level fusion, and fused to sacrum/pelvis. The primary outcome was rod fracture. Univariate/multivariate logistic regression was performed controlling for age, kickstand rod usage, number of rods across the lumbosacral junction (LSJ), and the amount of coronal/sagittal Cobb correction.
resultsAmong 57 patients undergoing ASD surgery with MRCs, mean age was 60 ± 11 years. With respect to MRCs, 32 (56%) patients had 3 rods, 18 (32%) had 4, and 7 (12%) had 5. Rods crossing the LSJ were most often three (63%), followed by four (25%) and five (5%) rods. Nine (16%) patients experienced rod fractures with eight (89%) patients having no more than three rods crossing the LSJ. A coronal correction > 30 mm was more often seen in patients with rod fracture (p = 0.030), while an SVA correction > 50 mm was not significantly different (p = 0.608). Multivariate logistic regression revealed that the amount of coronal correction was significantly associated with rod fracture (OR 1.03, 95% CI 1.01-1.07, p = 0.044), as was achieving a coronal correction > 30 mm (OR 7.72, 95% CI 1.17-51.10, p = 0.034), with no association between the amount of sagittal correction obtained and rod fracture.
conclusionThis study found that greater coronal correction was associated with an increased odds of rod fracture. We suggest adding at least four rods across the LSJ cephalad to the interbody fusions to avoid rod fractures in these high demand areas. LEVEL OF EVIDENCE: III.
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