Orthopaedic Surgery (Jun 2023)

Satellite Rod Fixation around Rod‐fracture Area in Revision Surgery after Three‐column Osteotomy for Severe Kyphoscoliosis

  • Dun Liu,
  • Benlong Shi,
  • Zhen Liu,
  • Xu Sun,
  • Zezhang Zhu,
  • Yong Qiu

DOI
https://doi.org/10.1111/os.13738
Journal volume & issue
Vol. 15, no. 6
pp. 1564 – 1570

Abstract

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Objective Three‐column osteotomy (3CO) is considered valuable and increasingly utilized in the surgical treatment of severe spine deformity while associated with high implant‐related complications and revision risks. This study aims to evaluate the feasibility and clinical outcomes of satellite rod fixation used around the rod‐fracture area in revision surgery due to rod fracture after 3CO. Methods Twenty‐five patients applying satellite rod fixation in revision surgery from August 2012 to May 2016 were retrospectively reviewed as the SR group. Patients undergoing revision surgery with traditional strategy after 3CO due to rod‐fracture were selected as the TR group. Cobb angle, distance between C7 plumb line and center sacral vertical line (C7PL‐CSVL), global kyphosis (GK) and sagittal vertical axis (SVA) were assessed. Patients were required to fulfill the Scoliosis Research Society‐22 questionnaire (SRS‐22) at pre‐revision and the last follow‐up. The paired t test was used to analyze the difference among pre‐revision, post‐revision and last follow‐up. Results There was no statistical difference in terms of age, gender, body mass index (BMI), fusion level at 1st surgery, and follow‐up period between SR and TR group (all P > 0.05). The operation time (1.5 ± 0.7 h vs 3.2 ± 0.9 h, P 0.05). All patients responded to the SRS‐22 questionnaire and all the domains showed improvements in different levels. As compared to the TR group, the SR group had significantly better pain and management satisfaction scores (all P < 0.05). Additionally, there was no reoccurrence of implant failure during follow‐up and all patients achieved solid bony fusion in SR group. Conclusion Satellite rod fixation around rod‐fracture area is indicated for patients in the requirement of revision surgeries due to rod fracture after 3CO. Compared with traditional revision strategies, revision surgery with satellite rods, if patients are selected adequately, is a simpler procedure with less intraoperative blood loss and shorter operating time.

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