Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis
Purpose Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the...
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| Veröffentlicht in: | European spine journal 2020-04, Vol.29 (4), p.886-895 |
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| creator | Guevara-Villazón, Fernando Boissiere, Louis Hayashi, Kazunori Larrieu, Daniel Ghailane, Soufiane Vital, Jean-Marc Gille, Olivier Pointillart, Vincent Obeid, Ibrahim Bourghli, Anouar |
| description | Purpose
Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.
Methods
This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up. Matching was considered with demographical data, preoperative radiographical parameters, preoperative clinical status [health-related quality-of-life (HRQoL) scores] and surgical characteristics (anterior fusion, decompression, rod material, osteotomies). Postoperative radiographical and clinical parameters, as well as complications, were obtained. Univariate and multivariate analysis was performed regarding postoperative improvement, group variables comparison and parameters correlation.
Results
Thirty-three patients with multi-rod construct and 33 matched with a two-rod construct were selected from a database with 346 ASD-operated patients. Both groups had a significant improvement with surgical management in the radiographical and HRQoL parameters (
p |
| doi_str_mv | 10.1007/s00586-020-06311-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2348230883</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2348230883</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-baf4676567521973994b53b3d401433989d5a464973604b180990e2d2a58bed33</originalsourceid><addsrcrecordid>eNp9kU1vFSEYhYnR2Gv1D7gwJG7coC8fw4A70_iV1HRT14SZYW5pmGEEpvH2D_Rvy3irJi66InCec17gIPSSwlsK0L7LAI2SBBgQkJxScvsI7ajgjIDm7DHagRZAZEv1CXqW8zUAbTTIp-iEU615q8QO3X1bQ_FLcCTFAfdxziWtfcnYz9gOVcN58bMNeHBjTJMvB5zXtHfpgOseLy7c-J6M_qctbsAhzvvq3DImNxdbfA18j-1cD4vbp5oz2dJfuW3UVUylSjYcss_P0ZPRhuxe3K-n6Punj5dnX8j5xeevZx_OSc_bppDOjkK2spFtw6huudaia3jHBwH14VwrPTRWSFElCaKjCrQGxwZmG9W5gfNT9OaYu6T4Y3W5mMnn3oVgZxfXbBgXinFQakNf_4dexzXV-26U4qpVIESl2JHqU8w5udEsyU82HQwFs9VkjjWZWpP5XZO5raZX99FrN7nhr-VPLxXgRyBXaa7f_W_2A7G_AFEMn4k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2383878044</pqid></control><display><type>article</type><title>Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis</title><source>SpringerLink Journals</source><creator>Guevara-Villazón, Fernando ; Boissiere, Louis ; Hayashi, Kazunori ; Larrieu, Daniel ; Ghailane, Soufiane ; Vital, Jean-Marc ; Gille, Olivier ; Pointillart, Vincent ; Obeid, Ibrahim ; Bourghli, Anouar</creator><creatorcontrib>Guevara-Villazón, Fernando ; Boissiere, Louis ; Hayashi, Kazunori ; Larrieu, Daniel ; Ghailane, Soufiane ; Vital, Jean-Marc ; Gille, Olivier ; Pointillart, Vincent ; Obeid, Ibrahim ; Bourghli, Anouar</creatorcontrib><description>Purpose
Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.
Methods
This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up. Matching was considered with demographical data, preoperative radiographical parameters, preoperative clinical status [health-related quality-of-life (HRQoL) scores] and surgical characteristics (anterior fusion, decompression, rod material, osteotomies). Postoperative radiographical and clinical parameters, as well as complications, were obtained. Univariate and multivariate analysis was performed regarding postoperative improvement, group variables comparison and parameters correlation.
Results
Thirty-three patients with multi-rod construct and 33 matched with a two-rod construct were selected from a database with 346 ASD-operated patients. Both groups had a significant improvement with surgical management in the radiographical and HRQoL parameters (
p
< 0.001). Differences between groups for the postoperative radiographical, clinical and perioperative parameters were not significant. Rod breakage was more frequent in the two-rod group (8 vs 4,
p
= 0.089), as well as the respective revision surgery for those cases (6 vs 1
p
= 0.046). Risk factors related to revision surgery were greater kyphosis correction (
p
= 0.001), longer instrumentation (
p
= 0.037) and greater sagittal vertical axis correction (
p
= 0.049).
Conclusion
No major disadvantage on the use of multi-rod construct was identified. This supports the benefit of using multi-rod constructs to avoid implant failure.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-020-06311-z</identifier><identifier>PMID: 31993784</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cohort analysis ; Decompression ; Kyphosis ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Neurosurgery ; Original Article ; Patients ; Risk factors ; Surgery ; Surgical Orthopedics</subject><ispartof>European spine journal, 2020-04, Vol.29 (4), p.886-895</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>European Spine Journal is a copyright of Springer, (2020). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-baf4676567521973994b53b3d401433989d5a464973604b180990e2d2a58bed33</citedby><cites>FETCH-LOGICAL-c375t-baf4676567521973994b53b3d401433989d5a464973604b180990e2d2a58bed33</cites><orcidid>0000-0002-2765-822X ; 0000-0002-3401-1838 ; 0000-0001-8831-1767</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-020-06311-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-020-06311-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31993784$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guevara-Villazón, Fernando</creatorcontrib><creatorcontrib>Boissiere, Louis</creatorcontrib><creatorcontrib>Hayashi, Kazunori</creatorcontrib><creatorcontrib>Larrieu, Daniel</creatorcontrib><creatorcontrib>Ghailane, Soufiane</creatorcontrib><creatorcontrib>Vital, Jean-Marc</creatorcontrib><creatorcontrib>Gille, Olivier</creatorcontrib><creatorcontrib>Pointillart, Vincent</creatorcontrib><creatorcontrib>Obeid, Ibrahim</creatorcontrib><creatorcontrib>Bourghli, Anouar</creatorcontrib><title>Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.
Methods
This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up. Matching was considered with demographical data, preoperative radiographical parameters, preoperative clinical status [health-related quality-of-life (HRQoL) scores] and surgical characteristics (anterior fusion, decompression, rod material, osteotomies). Postoperative radiographical and clinical parameters, as well as complications, were obtained. Univariate and multivariate analysis was performed regarding postoperative improvement, group variables comparison and parameters correlation.
Results
Thirty-three patients with multi-rod construct and 33 matched with a two-rod construct were selected from a database with 346 ASD-operated patients. Both groups had a significant improvement with surgical management in the radiographical and HRQoL parameters (
p
< 0.001). Differences between groups for the postoperative radiographical, clinical and perioperative parameters were not significant. Rod breakage was more frequent in the two-rod group (8 vs 4,
p
= 0.089), as well as the respective revision surgery for those cases (6 vs 1
p
= 0.046). Risk factors related to revision surgery were greater kyphosis correction (
p
= 0.001), longer instrumentation (
p
= 0.037) and greater sagittal vertical axis correction (
p
= 0.049).
Conclusion
No major disadvantage on the use of multi-rod construct was identified. This supports the benefit of using multi-rod constructs to avoid implant failure.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</description><subject>Cohort analysis</subject><subject>Decompression</subject><subject>Kyphosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vFSEYhYnR2Gv1D7gwJG7coC8fw4A70_iV1HRT14SZYW5pmGEEpvH2D_Rvy3irJi66InCec17gIPSSwlsK0L7LAI2SBBgQkJxScvsI7ajgjIDm7DHagRZAZEv1CXqW8zUAbTTIp-iEU615q8QO3X1bQ_FLcCTFAfdxziWtfcnYz9gOVcN58bMNeHBjTJMvB5zXtHfpgOseLy7c-J6M_qctbsAhzvvq3DImNxdbfA18j-1cD4vbp5oz2dJfuW3UVUylSjYcss_P0ZPRhuxe3K-n6Punj5dnX8j5xeevZx_OSc_bppDOjkK2spFtw6huudaia3jHBwH14VwrPTRWSFElCaKjCrQGxwZmG9W5gfNT9OaYu6T4Y3W5mMnn3oVgZxfXbBgXinFQakNf_4dexzXV-26U4qpVIESl2JHqU8w5udEsyU82HQwFs9VkjjWZWpP5XZO5raZX99FrN7nhr-VPLxXgRyBXaa7f_W_2A7G_AFEMn4k</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Guevara-Villazón, Fernando</creator><creator>Boissiere, Louis</creator><creator>Hayashi, Kazunori</creator><creator>Larrieu, Daniel</creator><creator>Ghailane, Soufiane</creator><creator>Vital, Jean-Marc</creator><creator>Gille, Olivier</creator><creator>Pointillart, Vincent</creator><creator>Obeid, Ibrahim</creator><creator>Bourghli, Anouar</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2765-822X</orcidid><orcidid>https://orcid.org/0000-0002-3401-1838</orcidid><orcidid>https://orcid.org/0000-0001-8831-1767</orcidid></search><sort><creationdate>20200401</creationdate><title>Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis</title><author>Guevara-Villazón, Fernando ; Boissiere, Louis ; Hayashi, Kazunori ; Larrieu, Daniel ; Ghailane, Soufiane ; Vital, Jean-Marc ; Gille, Olivier ; Pointillart, Vincent ; Obeid, Ibrahim ; Bourghli, Anouar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-baf4676567521973994b53b3d401433989d5a464973604b180990e2d2a58bed33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cohort analysis</topic><topic>Decompression</topic><topic>Kyphosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guevara-Villazón, Fernando</creatorcontrib><creatorcontrib>Boissiere, Louis</creatorcontrib><creatorcontrib>Hayashi, Kazunori</creatorcontrib><creatorcontrib>Larrieu, Daniel</creatorcontrib><creatorcontrib>Ghailane, Soufiane</creatorcontrib><creatorcontrib>Vital, Jean-Marc</creatorcontrib><creatorcontrib>Gille, Olivier</creatorcontrib><creatorcontrib>Pointillart, Vincent</creatorcontrib><creatorcontrib>Obeid, Ibrahim</creatorcontrib><creatorcontrib>Bourghli, Anouar</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guevara-Villazón, Fernando</au><au>Boissiere, Louis</au><au>Hayashi, Kazunori</au><au>Larrieu, Daniel</au><au>Ghailane, Soufiane</au><au>Vital, Jean-Marc</au><au>Gille, Olivier</au><au>Pointillart, Vincent</au><au>Obeid, Ibrahim</au><au>Bourghli, Anouar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>29</volume><issue>4</issue><spage>886</spage><epage>895</epage><pages>886-895</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
Multiple-rod constructs (Multi-Rod: extra rods for additional pillar support) are occasionally used in adult spinal deformity (ASD) surgery. We aimed to compare and analyze the general outcome of multi-rod constructs with a matched two-rod cohort, to better understand the differences and the similitudes.
Methods
This is a retrospective matched cohort study including patients with ASD that underwent surgical correction with long posterior instrumentation (more than five levels), pelvic fixation and a minimum 1-year follow-up. Matching was considered with demographical data, preoperative radiographical parameters, preoperative clinical status [health-related quality-of-life (HRQoL) scores] and surgical characteristics (anterior fusion, decompression, rod material, osteotomies). Postoperative radiographical and clinical parameters, as well as complications, were obtained. Univariate and multivariate analysis was performed regarding postoperative improvement, group variables comparison and parameters correlation.
Results
Thirty-three patients with multi-rod construct and 33 matched with a two-rod construct were selected from a database with 346 ASD-operated patients. Both groups had a significant improvement with surgical management in the radiographical and HRQoL parameters (
p
< 0.001). Differences between groups for the postoperative radiographical, clinical and perioperative parameters were not significant. Rod breakage was more frequent in the two-rod group (8 vs 4,
p
= 0.089), as well as the respective revision surgery for those cases (6 vs 1
p
= 0.046). Risk factors related to revision surgery were greater kyphosis correction (
p
= 0.001), longer instrumentation (
p
= 0.037) and greater sagittal vertical axis correction (
p
= 0.049).
Conclusion
No major disadvantage on the use of multi-rod construct was identified. This supports the benefit of using multi-rod constructs to avoid implant failure.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31993784</pmid><doi>10.1007/s00586-020-06311-z</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2765-822X</orcidid><orcidid>https://orcid.org/0000-0002-3401-1838</orcidid><orcidid>https://orcid.org/0000-0001-8831-1767</orcidid></addata></record> |
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| ispartof | European spine journal, 2020-04, Vol.29 (4), p.886-895 |
| issn | 0940-6719 1432-0932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2348230883 |
| source | SpringerLink Journals |
| subjects | Cohort analysis Decompression Kyphosis Medicine Medicine & Public Health Multivariate analysis Neurosurgery Original Article Patients Risk factors Surgery Surgical Orthopedics |
| title | Multiple-rod constructs in adult spinal deformity surgery for pelvic-fixated long instrumentations: an integral matched cohort analysis |
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