Pedicle subtraction osteotomy yielded better lumbopelvic mismatch correction in primary surgery
Pedicle subtraction osteotomies offer similar sagittal correction rates and complication rates in the primary and revision surgical settings, but investigators in this study observed better lumbopelvic mismatch correction in patients who underwent primary pedicle subtraction osteotomy.
Researchers conducted a multicenter, prospective study to compare the outcomes of pedicle subtraction osteotomies (PSO) in the primary and revision surgical setting for patients with adult spinal deformity. Baseline demographics, radiographic parameters, complications and revision rates were compared with 1-year outcomes.
A total of 421 patients were included, with 70 patients who underwent primary PSO and 351 patients who underwent revision PSO. At 1-year follow-up, both groups demonstrated significant improvements in all sagittal spinopelvic parameters. Pelvic mismatch improved to grade 0 more often in the primary surgical setting (83%) than the revision setting (57%), researchers noted.
Within the first year of PSO, the overall revision rate of primary surgeries was 4.3% and it was 7.4% for the revision surgeries.
Researchers found no statistically significant difference in the complication rates for the two groups at 6 weeks postoperatively. The primary and revision PSO groups experienced overall complication rates of 24.3% and 31.9%, respectively.
Researchers concluded PSO is safely performed in both the primary and revision settings of adult spinal deformity surgery and both groups achieved successful angular correction with the PSO resection. – by Robert Linnehan
Disclosure: The researchers report receiving DePuy Spine grant funds for the study.