STUDY DESIGN: Author experience and literature review. OBJECTIVES: To compare different revision techniques in the treatment of implant failure after pedicle subtraction osteotomy (PSO). The complication rate of pedicle subtraction osteotomy is substantially higher than other corrective procedures available for the treatment of spinal sagittal imbalance: in particular, hardware failures and mechanical complications affect this technique and their biomechanical explanation is still purely speculative. METHODS: The author's experience and the literature regarding the revision techniques for PSO failures are discussed. RESULTS: In this paper, eight consecutive revision cases due to rod breakage after PSO surgery are reported. In our experience, the main goals are to restore the spinal balance, through a posterior approach (correction and hardware revision and implementation) and to get a solid anterior fusion (both through a traditional anterior approach or minimally invasive transpsoas approach). CONCLUSION: The efficacy of PSO should be balanced with the high risk of the procedure reported in the literature. Management of revision surgery after PSO may require the addition of anterior column support to maintain correction and reduce complications.
STUDY DESIGN: Author experience and literature review. OBJECTIVES: To compare different revision techniques in the treatment of implant failure after pedicle subtraction osteotomy (PSO). The complication rate of pedicle subtraction osteotomy is substantially higher than other corrective procedures available for the treatment of spinal sagittal imbalance: in particular, hardware failures and mechanical complications affect this technique and their biomechanical explanation is still purely speculative. METHODS: The author's experience and the literature regarding the revision techniques for PSO failures are discussed. RESULTS: In this paper, eight consecutive revision cases due to rod breakage after PSO surgery are reported. In our experience, the main goals are to restore the spinal balance, through a posterior approach (correction and hardware revision and implementation) and to get a solid anterior fusion (both through a traditional anterior approach or minimally invasive transpsoas approach). CONCLUSION: The efficacy of PSO should be balanced with the high risk of the procedure reported in the literature. Management of revision surgery after PSO may require the addition of anterior column support to maintain correction and reduce complications.
Authors: Justin S Smith; Charles A Sansur; William F Donaldson; Joseph H Perra; Ram Mudiyam; Theodore J Choma; Reinhard D Zeller; D Raymond Knapp; Hilali H Noordeen; Sigurd H Berven; Michael J Goytan; Oheneba Boachie-Adjei; Christopher I Shaffrey Journal: Spine (Phila Pa 1976) Date: 2011-05-20 Impact factor: 3.468
Authors: Samuel K Cho; Keith H Bridwell; Lawrence G Lenke; Jin-Seok Yi; Joshua M Pahys; Lukas P Zebala; Matthew M Kang; Woojin Cho; Christine R Baldus Journal: Spine (Phila Pa 1976) Date: 2012-03-15 Impact factor: 3.468
Authors: Yongjung J Kim; Keith H Bridwell; Lawrence G Lenke; Gene Cheh; Christine Baldus Journal: Spine (Phila Pa 1976) Date: 2007-09-15 Impact factor: 3.468
Authors: Keith H Bridwell; Stephen J Lewis; Charles Edwards; Lawrence G Lenke; Theresa M Iffrig; Annette Berra; Christine Baldus; Kathy Blanke Journal: Spine (Phila Pa 1976) Date: 2003-09-15 Impact factor: 3.468
Authors: Justin S Smith; Christopher I Shaffrey; Christopher P Ames; Jason Demakakos; Kai-Ming G Fu; Sassan Keshavarzi; Carol M Y Li; Vedat Deviren; Frank J Schwab; Virginie Lafage; Shay Bess Journal: Neurosurgery Date: 2012-10 Impact factor: 4.654
Authors: Luigi La Barbera; Hans-Joachim Wilke; Christian Liebsch; Tomaso Villa; Andrea Luca; Fabio Galbusera; Marco Brayda-Bruno Journal: Eur Spine J Date: 2019-08-14 Impact factor: 3.134
Authors: Iulian Popa; Manuel Oprea; Diana Andrei; Peter Mercedesz; Mihai Mardare; Dan V Poenaru Journal: Int Orthop Date: 2016-02-24 Impact factor: 3.075
Authors: Luigi La Barbera; Marco Brayda-Bruno; Christian Liebsch; Tomaso Villa; Andrea Luca; Fabio Galbusera; Hans-Joachim Wilke Journal: Eur Spine J Date: 2018-05-08 Impact factor: 3.134