Rod Strain After Pedicle Subtraction Osteotomy: A Biomechanical Study

Area of Science:

• Spine surgery
• Orthopedics
• Adult spinal deformity

Background:

• Pedicle subtraction osteotomy (PSO) is a major surgical technique for correcting adult spinal deformity.
• PSO can achieve significant sagittal correction, sometimes exceeding 30°.
• However, PSO is associated with high failure rates, reaching up to 46% after 5 years.

Purpose of the Study:

• To highlight the challenges and complications associated with Pedicle subtraction osteotomy.
• To emphasize the need for strategies to avoid revision surgeries in patients with spinal deformity.

Main Methods:

• Review of reported outcomes and failure rates of PSO.
• Analysis of complications, including rod breakage, in older patients with fixed sagittal imbalance.

Main Results:

• PSO failure rates can be as high as 30% within 2 years and 46% by 4-5 years.
• Rod breakage is a common complication in older patients, leading to multiple revisions.
• Revision surgery after PSO failure is challenging for patients.

Conclusions:

• While PSO can achieve substantial correction, its high failure rate and associated complications necessitate careful consideration.
• Strategies to prevent complications like rod breakage and minimize revision surgeries are essential for improving patient outcomes in adult spinal deformity correction.