Anouar Bourghli1, Louis Boissiere2, Derek Cawley3, Daniel Larrieu2, Javier Pizones4, Ahmet Alanay5, Ferran PelIise6, Franck Kleinstück7, Ibrahim Obeid2. 1. Orthopedic and Spinal Surgery Department, Kingdom Hospital, P.O.Box 84400, Riyadh, 11671, Saudi Arabia. Anouar.bourghli@gmail.com. 2. Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France. 3. Mater Private Hospital, Dublin, Ireland. 4. Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain. 5. Spine Surgery Unit, Acibadem Maslak Hospital, Istanbul, Turkey. 6. Spine Surgery Unit, Hospital Universitario Val Hebron, Barcelona, Spain. 7. Spine Center, Schulthess Klinik, Zurich, Switzerland.
Abstract
PURPOSE: To compare the radiological outcomes and complications of adult spinal deformity patients who underwent a pedicle subtraction osteotomy (PSO) below L2 but categorized according to their construct where either a domino connector was applied for osteotomy correction or not. METHODS: Retrospective review of a prospective, multicenter adult spinal deformity database (5 sites). Inclusion criteria were adult patients who underwent PSO between L3 and L5 with a minimum follow-up of 2 years. Among 1243 patients in the database, 79 met the inclusion criteria, 41 in the no-domino (ND) group and 38 in the domino (D) group. The domino technique consisted of using 2 parallel rods connected by a domino on one side of the PSO in order to achieve gradual and controlled compression at the osteotomy site. Demographic data, operative parameters, spinopelvic parameters and complications were collected. RESULTS: Demographic data and operative parameters were globally similar between both groups, and they showed a comparable preoperative sagittal malalignment. Segmental lordosis improved by 22° and 31° (p < 0.05) and L1S1 lordosis improved by 23° and 32° (p < 0.05) in the ND and D group, respectively. The use of multiple rods was similar between the groups (58% vs. 57%). Also, mechanical complications rate was globally similar between both groups with no statistically significant difference (22% vs. 28.9%). CONCLUSION: Domino connector is a safe, powerful and efficient tool for pedicle subtraction osteotomy site closure. It improved the lumbar lordosis correction angle with an acceptable rate of complications.
PURPOSE: To compare the radiological outcomes and complications of adult spinal deformity patients who underwent a pedicle subtraction osteotomy (PSO) below L2 but categorized according to their construct where either a domino connector was applied for osteotomy correction or not. METHODS: Retrospective review of a prospective, multicenter adult spinal deformity database (5 sites). Inclusion criteria were adult patients who underwent PSO between L3 and L5 with a minimum follow-up of 2 years. Among 1243 patients in the database, 79 met the inclusion criteria, 41 in the no-domino (ND) group and 38 in the domino (D) group. The domino technique consisted of using 2 parallel rods connected by a domino on one side of the PSO in order to achieve gradual and controlled compression at the osteotomy site. Demographic data, operative parameters, spinopelvic parameters and complications were collected. RESULTS: Demographic data and operative parameters were globally similar between both groups, and they showed a comparable preoperative sagittal malalignment. Segmental lordosis improved by 22° and 31° (p < 0.05) and L1S1 lordosis improved by 23° and 32° (p < 0.05) in the ND and D group, respectively. The use of multiple rods was similar between the groups (58% vs. 57%). Also, mechanical complications rate was globally similar between both groups with no statistically significant difference (22% vs. 28.9%). CONCLUSION: Domino connector is a safe, powerful and efficient tool for pedicle subtraction osteotomy site closure. It improved the lumbar lordosis correction angle with an acceptable rate of complications.
Authors: Seung-Jae Hyun; Lawrence G Lenke; Yong Chan Kim; Linda A Koester; Kathy M Blanke Journal: Spine (Phila Pa 1976) Date: 2015-04-01 Impact factor: 3.468
Authors: Kota Watanabe; Lawrence G Lenke; Michael D Daubs; Young-Woo Kim; Youngbae B Kim; Kei Watanabe; Georgia Stobbs Journal: Spine (Phila Pa 1976) Date: 2008-05-01 Impact factor: 3.468