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European Spine Journal
Published in: European Spine Journal 6/2013

01-11-2013 | Original Article

Failures and revisions in surgery for sagittal imbalance: analysis of factors influencing failure

Authors: P. Berjano, R. Bassani, G. Casero, A. Sinigaglia, R. Cecchinato, C. Lamartina

Published in: European Spine Journal | Special Issue 6/2013

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Abstract

Introduction

Sagittal imbalance is an important risk factor for spinal disability, pain and loss of health related quality of life. Its correction has a positive impact on these outcomes. Still, it is a very aggressive surgery, with a high revision rate. The aim of this study is to analyze the most important causes of failure of surgery for correction of sagittal imbalance.

Design and methods

In this retrospective observational cohort study twelve patients who previously underwent surgery for sagittal imbalance correction were revised in the period 2009–10. We analyzed angular parameters of sagittal balance before and after primary surgery, type of instrumentation, modality of fusion, implant density, instrumented levels, modality of failure, time from first surgery and angular parameters after revision.

Results and conclusion

Causes of failure were insufficient correction, junctional kyphosis, screw loosening and pseudoarthrosis with rod breakage. In every case, patients presented a new onset or a worsening of sagittal imbalance and pain.
Literature
1.
Booth KC, Bridwell KH, Lenke LG, Baldus CR, Blanke KM (1999) Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine (Phila Pa 1976) 24:1712–1720CrossRef
2.
Casey MP, Asher MA, Jacobs RR, Orrick JM (1987) The effect of Harrington rod contouring on lumbar lordosis. Spine (Phila Pa 1976) 12:750–753CrossRef
3.
Farcy JP, Schwab FJ (1997) Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976) 22:2452–2457CrossRef
4.
Glassman SD, Berven S, Bridwell K et al (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa 1976) 30:682–688CrossRef
5.
Bridwell KH (2006) Decision making regarding Smith–Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine (Phila Pa 1976) 31(19 Suppl):S171–S178CrossRef
6.
Kim KT, Lee SH, Suk KS, Lee JH, Jeong BO (2012) Outcome of pedicle subtraction osteotomies for fixed sagittal imbalance of multiple etiologies. A retrospective review of 140 patients. Spine (Phila Pa 1976) 37(19):1667–1675CrossRef
7.
Smith JS, Sansur CA, Donaldson WF III, Perra JH, Mudiyam R, Choma TJ, Zeller RD, Knapp DR, Noordeen HH, Berven SH, Goytan MJ, Boachie-Adjei O, Shaffrey CI (2011) Short-term morbidity and mortality associated with correction of thoracolumbar fixed sagittal plane deformity. A report from the Scoliosis Research Society morbidity and mortality committee. Spine 36(12):958–964CrossRefPubMed
8.
Hyun SJ, Rhim SC (2010) Clinical outcomes and complications after pedicle subtraction osteotomy for fixed sagittal imbalance patients: a long-term follow-up data. Korean Neurosurg Soc 47:95–101CrossRef
9.
Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R, Damilano M, Bassani R (2012) Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Eur Spine J 21(Suppl 1):S27–S31CrossRefPubMed
10.
Le Huec JC, Leijssen P, Duarte M, Aunoble S (2011) Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique. Eur Spine J 20(Suppl 5):S669–S680CrossRef
11.
Yang PB, Ondra SL (2006) A method for calculating the exact angle required during Pedicle Subtraction Osteotomy for fixed sagittal deformity: comparison with the trigonometric method. Neurosurgery 59(4 Suppl 2):ONS458–ONS463PubMed
Metadata
Title
Failures and revisions in surgery for sagittal imbalance: analysis of factors influencing failure
Authors
P. Berjano
R. Bassani
G. Casero
A. Sinigaglia
R. Cecchinato
C. Lamartina
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 6/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3024-x

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