ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Surgical planning for spinal deformity correction: the contribution of patient-specific rods.
Article in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
STUDY
designRetrospective analysis of a prospectively maintained single-center cohort.
objectivesTo evaluate the accuracy and mid-term durability of sagittal correction in adult spinal deformity (ASD) patients treated with patient-specific rods (PSR) using the SD-based goal-attainment method described by Smith et al. Secondary objectives were to identify predictors of alignment goal attainment and to characterize complication rates.
methodsConsecutive ASD patients undergoing thoracolumbar fusion with PSR (UNID®, cobalt–chrome, 6 mm) between 2015 and 2020 were analyzed. Planned sagittal targets (LL, SVA, TK, PT) were compared with preoperative, early postoperative (< 6 weeks), and ≥ 36-month follow-up measurements. Goal attainment was defined as achieving values within ± 1 cohort SD of the planned target. Multivariable logistic regression identified predictors of goal attainment.
resultsAmong 145 patients (mean age 65.3 years; 71.3% women; mean fusion length 11.8 levels), PSR increased lumbar lordosis from 31.8° to 52.0° postoperatively and 49.3° at last follow-up (planned 55.8°). Sagittal vertical axis decreased from 79.8 mm to 39.3 mm postoperatively and 53.0 mm at follow-up (planned 8.6 mm). Goal attainment was 60.9% for LL, 62.2% for SVA, 77.3% for TK, and 45.1% for PT; 45.5% achieved all three primary targets. Higher pelvic incidence predicted LL undercorrection, whereas > 3 osteotomies and lower BMI favored global goal attainment.ODI improved from 60.6 ± 13.4% to 35.7 ± 13.3% (Δ =−24.9, p < 0.001); EVAL from 7.0 ± 1.6 to 3.5 ± 1.7 (Δ =−3.5, p < 0.001); and EVAR from 5.4 ± 2.5 to 1.7 ± 2.0 (Δ=−3.7, p < 0.001).
conclusionsPatient-specific rods appear to significantly improve the accuracy and mid-term durability of sagittal alignment in ASD. Nearly half of patients achieved all primary alignment goals. PSR may represent a promising tool to standardize sagittal realignment. LEVEL OF EVIDENCE: 3
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