Comparison of degenerative lumbar scoliosis correction and risk for mechanical failure using posterior 2-rod instrumentation versus 4-rod instrumentation and interbody fusion

Lamas, Vincent; Charles, Yann Philippe; Tuzin, Nicolas; Steib, Jean-Paul

doi:10.1007/s00586-021-06870-9

Cited by 10 publications

(3 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results suggest that multiple rod constructs provide greater relief from symptoms, as compared to single-rod constructs. The use of more rods is associated with greater improvement of spinal deformity and lower incidence of revision surgery as a consequence of rod strain and fracture (Banno et al, 2019; Bourghli et al, 2021; Guevara-Villazón et al, 2020; Hyun et al, 2014; Lamas et al, 2021). In addition, the degree of benefit can be seen as a function of traditional versus non-traditional strategies or techniques, symmetric versus asymmetric placement, and the type of material used.…”

Section: Resultsmentioning

confidence: 99%

Comprehensive Evaluation and Analysis of Multi-Rod Constructs in Adult Spinal Deformity

Azzam

2023

Preprint

View full text Add to dashboard Cite

Adult Spinal Deformity (ASD) is a degenerative condition of the spinal column that is categorized by sagittal imbalance, iatrogenic spinal deformity, and abnormal spinal curvature and leads to diminished quality of life. ASD is frequently repaired via neurological or orthopedic spine surgery to restore normal curvature and alignment. Surgical correction often involves the use of single, dual, or multiple-rod constructs. Multirod constructs, in particular, offer improved stability and deformity adjustment that is unmatched by single and multi-rod assemblies, but may include significant disadvantages. This review seeks to weigh the costs and benefits associated with the use of multiple rods in adult spinal deformity surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Comprehensive Evaluation and Analysis of Multi-Rod Constructs in Adult Spinal Deformity

Azzam

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Satisfactory correction of misalignment with proximal and distal ends of the implant in neutral load zones (close to the gravity line), multiple fixation points and multiple rod constructs may help reduce risk of revision surgery [ 18 ]. Multi-rod constructs have shown to reduce the rate of pseudoarthrosis and mechanical complications in adult deformity surgery [ 19 , 20 ]. When the surgical therapy of spinal RDOA requires long fusion, the use of multi-rod constructs may improve the posterior load sharing thus limiting the risk of cage subsidence.…”

Section: Discussionmentioning

confidence: 99%

Rapidly destructive osteoarthritis of the spine: lessons learned from the first reported case

Baroncini

Berjano

Migliorini

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Rapidly Destructive Osteoarthritis (RDOA) has been described for the hip and shoulder joints and is characterized by a quickly developing bone edema followed by extensive remodeling and joint destruction. Confronted with a similarly evolving case of endplate edema and destruction of the disk space, we offer the first described case of spinal RDOA and illustrate the challenges it presented, along with the strategies we put in place to overcome them. Case presentation We present a case of spinal RDOA that, also due to the delay in the diagnoses, underwent multiple revisions for implant failure with consequent coronal and sagittal imbalance. A 37-years-old, otherwise healthy female presented with atraumatic low back pain: after initial conservative treatment, subsequent imaging showed rapidly progressive endplate erosion and a scoliotic deformity. After surgical treatment, the patient underwent numerous revisions for pseudoarthrosis, coronal and sagittal imbalance and junctional failure despite initially showing a correct alignement after each surgery. As a mechanic overload from insufficient correction of the alignement of the spine was ruled out, we believe that the multiple complications were caused by an impairment in the bone structure and thus, reviewing old imaging, diagnosed the patient with spinal RDOA. In case of spinal RDOA, particular care should be placed in the choice of extent and type of instrumentation in order to prevent re-intervention. Conclusion Spinal RDOA is characterized by a quickly developing edema of the vertebral endplates followed by a destruction of the disk space within months from the first diagnosis. The disease progresses in the involved segment and to the adjacent disks despite surgical therapy. The surgical planning should take the impaired bone structure account and the use of large interbody cages or 4-rod constructs should be considered to obtain a stable construct.

show abstract

“…The culprits of RF were pseudarthrosis and the increasing fatigue cracks under external stress (Yamanaka et al, 2015;Sardi et al, 2022). We reviewed and synthesised the data of all published clinical studies comparing the mechanical complication rate between two-rod construct and multirod construct, and a significantly lower Frontiers in Bioengineering and Biotechnology frontiersin.org incidence of pseudarthrosis (14.2% vs. 35.0%) and RF (15.8% vs. 32.9%) was detected in patients undergoing multirod construct (Hyun et al, 2014;Han et al, 2017;Merrill et al, 2017;Guevara-Villazón et al, 2020;Yamato et al, 2020;Bourghli et al, 2021;Dinizo et al, 2021;Lamas et al, 2021;Rabinovich et al, 2021;Lyu et al, 2022). There are two options to anchor the distal end of accessory rods, including domino connectors and multiple pelvic screws.…”

Section: Figurementioning

confidence: 99%

Biomechanical evaluation of multiple pelvic screws and multirod construct for the augmentation of lumbosacral junction in long spinal fusion surgery

Yang

Pan

Hai

et al. 2023

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Background: Posterior long spinal fusion was the common procedure for adult spinal deformity (ASD). Although the application of sacropelvic fixation (SPF), the incidence of pseudoarthrosis and implant failure is still high in long spinal fusion extending to lumbosacral junction (LSJ). To address these mechanical complications, advanced SPF technique by multiple pelvic screws or multirod construct has been recommended. This was the first study to compare the biomechanical performance of combining multiple pelvic screws and multirod construct to other advanced SPF constructs for the augmentation of LSJ in long spinal fusion surgery through finite element (FE) analysis.Methods: An intact lumbopelvic FE model based on computed tomography images of a healthy adult male volunteer was constructed and validated. The intact model was modified to develop five instrumented models, all of which had bilateral pedicle screw (PS) fixation from L1 to S1 with posterior lumbar interbody fusion and different SPF constructs, including No-SPF, bilateral single S2-alar-iliac (S2AI) screw and single rod (SS-SR), bilateral multiple S2AI screws and single rod (MS-SR), bilateral single S2AI screw and multiple rods (SS-MR), and bilateral multiple S2AI screws and multiple rods (MS-MR). The range of motion (ROM) and stress on instrumentation, cages, sacrum, and S1 superior endplate (SEP) in flexion (FL), extension (EX), lateral bending (LB), and axial rotation (AR) were compared among models.Results: Compared with intact model and No-SPF, the ROM of global lumbopelvis, LSJ, and sacroiliac joint (SIJ) was decreased in SS-SR, MS-SR, SS-MR, and MS-MR in all directions. Compared with SS-SR, the ROM of global lumbopelvis and LSJ of MS-SR, SS-MR, and MS-MR further decreased, while the ROM of SIJ was only decreased in MS-SR and MS-MR. The stress on instrumentation, cages, S1-SEP, and sacrum decreased in SS-SR, compared with no-SPF. Compared with SS-SR, the stress in EX and AR further decreased in SS-MR and MS-SR. The most significantly decreased ROM and stress were observed in MS-MR.Conclusion: Both multiple pelvic screws and multirod construct could increase the mechanical stability of LSJ and reduce stress on instrumentation, cages, S1-SEP, and sacrum. The MS-MR construct was the most adequate to reduce the risk of lumbosacral pseudarthrosis, implant failure, and sacrum fracture. This study may provide surgeons with important evidence for the application of MS-MR construct in the clinical settings.

show abstract

Comparison of degenerative lumbar scoliosis correction and risk for mechanical failure using posterior 2-rod instrumentation versus 4-rod instrumentation and interbody fusion

Cited by 10 publications

References 40 publications

Comprehensive Evaluation and Analysis of Multi-Rod Constructs in Adult Spinal Deformity

Comprehensive Evaluation and Analysis of Multi-Rod Constructs in Adult Spinal Deformity

Rapidly destructive osteoarthritis of the spine: lessons learned from the first reported case

Biomechanical evaluation of multiple pelvic screws and multirod construct for the augmentation of lumbosacral junction in long spinal fusion surgery

Contact Info

Product

Resources

About