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Characteristics and Risk Factors of Rod Fracture Following Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

 Sung Hyun Noh  ;  Kyung Hyun Kim  ;  Jeong Yoon Park  ;  Sung Uk Kuh  ;  Keun Su Kim  ;  Yong Eun Cho  ;  Dong Kyu Chin 
 NEUROSPINE, Vol.18(3) : 447-454, 2021-09 
Journal Title
Issue Date
Adult spinal deformity ; Incidence ; Meta-analysis ; Risk factors ; Rod fracture ; Surgery
Objective: The aim of study is to investigate the features and risk factors of rod fracture (RF) following adult spinal deformity (ASD) surgery.

Methods: We searched the PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies. Patient's data including age, sex, body mass index (BMI), previous spine surgery, pedicle subtraction osteotomy (PSO), interbody fusion, fusion to the pelvis, smoking history, preoperative sagittal vertical axis (SVA), preoperative pelvic tilt (PT), preoperative pelvic incidence minus lumbar lordosis, preoperative thoracic kyphosis (TK), and change in the SVA were documented. Comparable factors were evaluated using odds ratio (OR) and weighted mean difference (WMD) with 95% confidence interval (CI).

Results: Seven studies were included. The overall incidence of RF following ASD surgery was 12%. Advanced age (WMD, 2.8; 95% CI, 1.01-4.59; p < 0.002), higher BMI (WMD, 1.98; 95% CI, 0.65-3.31; p = 0.004), previous spine surgery (OR, 1.47; 95% CI, 1.05-2.04; p = 0.02), PSO (OR, 2.28; 95% CI, 1.62-3.19; p < 0.0001), a larger preoperative PT (WMD, 6.17; 95% CI, 3.55-8.97; p < 0.00001), and a larger preoperative TK (WMD, 5.19; 95% CI, 1.41-8.98; p = 0.007) were identified as risk factors for incidence of RF.

Conclusion: The incidence of RF in patients following ASD surgery was 12%. Advanced age, higher BMI, previous spine surgery, and PSO were significantly associated with an increased occurrence of RF. A larger preoperative PT and TK were also identified as risk factors for occurrence of RF following ASD surgery.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Noh, Sung Hyun(노성현)
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
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