Multiple-rod constructs and use of bone morphogenetic protein–2 in relation to lower rod fracture rates in 141 patients with adult spinal deformity who underwent lumbar pedicle subtraction osteotomy

OBJECTIVE The purpose of this study was to compare rod fracture (RF) rates among three types constructs (RCs) following lumbar pedicle subtraction osteotomy (PSO) for adult spinal deformity (ASD). METHODS A retrospective review consecutive patients with who were treated PSO between 2007 and 2017 performed. minimum follow-up 2 years. Three RCs compared: standard (2 main rods), satellite rods rod), nested short spanning osteotomy). Outcomes examined included RF rate, time RF, pseudarthrosis, reoperation. Multivariate analysis used. RESULTS total 141 55 standard, 23 satellite, 63 RCs. mean age 65.2 years 34.8% male. Radiographic preoperative postoperative results as follows: sagittal vertical axis (11.0 vs 3.9 cm), lordosis (28.5° 57.1°), pelvic tilt (30.6° 21.0°), incidence (61.5° 60.0°), distance central sacral line C7 plumb (2.2 1.5 scoliosis (18.9° 11.3°). average 12.4 months. Overall bilateral reoperation 22.7%, 5.0%, 20.6%, 17.7%, respectively. Standard had a significantly higher (36.4% 13.0% 14.3%, p = 0.008), (35.0% 0.0% 0.0%, 0.021), pseudarthrosis (34.5% 8.7% 12.7%, 0.004), (30.9% 4.3% 11.1%, 0.004) rates. Satellite (OR 0.21, 0.015), 0.24, 0.003), bone morphogenetic protein–2 0.28, 0.005) independently associated lower odds RF. CONCLUSIONS Use multiple in the RC groups reoperations PSO. Bone reduction rate well.