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Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity.

Publication ,  Journal Article
Smith, JS; Shaffrey, CI; Ames, CP; Demakakos, J; Fu, K-MG; Keshavarzi, S; Li, CMY; Deviren, V; Schwab, FJ; Lafage, V; Bess, S ...
Published in: Neurosurgery
October 2012

BACKGROUND: Improved understanding of rod fracture (RF) in adult spinal deformity could be valuable for implant design, surgical planning, and patient counseling. OBJECTIVE: To evaluate symptomatic RF after posterior instrumented fusion for adult spinal deformity. METHODS: A multicenter, retrospective review of RF in adult spinal deformity was performed. Inclusion criteria were spinal deformity, age older than 18 years, and more than 5 levels posterior instrumented fusion. Rod failures were divided into early (≤12 months) and late (>12 months). RESULTS: Of 442 patients, 6.8% had symptomatic RF. RF rates were 8.6% for titanium alloy, 7.4% for stainless steel, and 2.7% for cobalt chromium. RF incidence after pedicle subtraction osteotomy (PSO) was 15.8%. Among patients with a PSO and RF, 89% had RF at or adjacent to the PSO. Mean time to early RF (63%) was 6.4 months (range, 2-12 months). Mean time to late RF (37%) was 31.8 months (range, 14-73 months). The majority of RFs after PSO (71%) were early (mean, 10 months). Among RF cases, mean sagittal vertical axis improved from preoperative (163 mm) to postoperative (76.9 mm) measures (P<.001); however, 16 had postoperative malalignment (sagittal vertical axis>50 mm; mean, 109 mm). CONCLUSION: Symptomatic RF occurred in 6.8% of adult spinal deformity cases and in 15.8% of PSO patients. The rate of RF was lower with cobalt chromium than with titanium alloy or stainless steel. Early failure was most common after PSO and favored the PSO site, suggesting that RF may be caused by stress at the PSO site. Postoperative sagittal malalignment may increase the risk of RF.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

October 2012

Volume

71

Issue

4

Start / End Page

862 / 867

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Spinal Fusion
  • Spinal Fractures
  • Spinal Curvatures
  • Retrospective Studies
  • Postoperative Complications
  • Pain
  • Osteotomy
  • Neurology & Neurosurgery
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Smith, J. S., Shaffrey, C. I., Ames, C. P., Demakakos, J., Fu, K.-M., Keshavarzi, S., … International Spine Study Group, . (2012). Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity. Neurosurgery, 71(4), 862–867. https://doi.org/10.1227/NEU.0b013e3182672aab
Smith, Justin S., Christopher I. Shaffrey, Christopher P. Ames, Jason Demakakos, Kai-Ming G. Fu, Sassan Keshavarzi, Carol M. Y. Li, et al. “Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity.Neurosurgery 71, no. 4 (October 2012): 862–67. https://doi.org/10.1227/NEU.0b013e3182672aab.
Smith JS, Shaffrey CI, Ames CP, Demakakos J, Fu K-MG, Keshavarzi S, et al. Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity. Neurosurgery. 2012 Oct;71(4):862–7.
Smith, Justin S., et al. “Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity.Neurosurgery, vol. 71, no. 4, Oct. 2012, pp. 862–67. Pubmed, doi:10.1227/NEU.0b013e3182672aab.
Smith JS, Shaffrey CI, Ames CP, Demakakos J, Fu K-MG, Keshavarzi S, Li CMY, Deviren V, Schwab FJ, Lafage V, Bess S, International Spine Study Group. Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity. Neurosurgery. 2012 Oct;71(4):862–867.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

October 2012

Volume

71

Issue

4

Start / End Page

862 / 867

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Spinal Fusion
  • Spinal Fractures
  • Spinal Curvatures
  • Retrospective Studies
  • Postoperative Complications
  • Pain
  • Osteotomy
  • Neurology & Neurosurgery