A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy

Muzammil Mumtaz; Justin Mendoza; Ardalan Seyed Vosoughi; Anthony S. Unger; Vijay K. Goel

doi:10.14245/ns.2142450.225

A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy

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Type: Academic journal

Author: Muzammil Mumtaz (The University of Toledo) Justin Mendoza (The University of Toledo) Ardalan Seyed Vosoughi (The University of Toledo) Anthony S. Unger (Department of Orthopaedic Surgery Sibley Gildenhorn Institute Johns Hopkins University) Vijay K. Goel (The University of Toledo)

Journal: The Korean Spinal Neurosurgery Society Neurospine Neurospine 제18권 제3호

Published: 2021.9

Pages: 587 - 596 (10page)

DOI: 10.14245/ns.2142450.225

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A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy

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Objective: The objective of this study was to compare the biomechanical differences of different rod configurations following anterior column realignment (ACR) and pedicle subtraction osteotomy (PSO) for an optimal correction technique and rod configuration that would minimize the risk of rod failure. Methods: A validated spinopelvic (L1-pelvis) finite element model was used to simulate ACR at the L3?4 level. The ACR procedure was followed by dual-rod fixation, and for 4-rod constructs, either medial/lateral accessory rods (connected to primary rods) or satellite rods (directly connected to ACR level screws). The range of motion (ROM), maximum von Mises stress on the rods, and factor of safety (FOS) were calculated for the ACR models and compared to the existing literature of different PSO rod configurations. Results: All of the 4-rod ACR constructs showed a reduction in ROM and maximum von Mises stress compared to the dual-rod ACR construct. Additionally, all of the 4-rod ACR constructs showed greater percentage reduction in ROM and maximum von Mises stress compared to the PSO 4-rod configurations. The ACR satellite rod construct had the maximum stress reduction i.e., 47.3% compared to dual-rod construct and showed the highest FOS (4.76). These findings are consistent with existing literature that supports the use of satellite rods to reduce the occurrence of rod fracture. Conclusion: Our findings suggest that the ACR satellite rod construct may be the most beneficial in reducing the risk of rod failure compared to all other PSO and ACR constructs.

#Adult spinal deformity #Anterior column realignment #Multirod constructs #Finite element analysis #Rod fracture #Pedicle subtraction osteotomy

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Godzik J / 2019 / Retrospective multicenter assessment of rod fracture after anterior column realignment in minimally invasive adult spinal deformity correction / World Neurosurg 130:e400~e405

Safaee MM / 2020 / Epidemiology and socioeconomic trends in adult spinal deformity care / Neurosur-gery 87:25~32

Kanter AS / 2014 / Introduction:adult spinal deformity: pathophysiology and corrective measures / Neurosurg Focus 36

Gupta MC / 2020 / Pedicle subtraction osteotomy / JBJS Essent Surg Tech 10:e0028.1~e0028.11

현승재 / 2010 / Clinical Outcomes and Complications after Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance Patients : A Long-Term Follow-Up Data / 대한신경외과학회지 47(2):95~101

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