Akademik Veri Yönetim Sistemi
EUROPEAN SPINE JOURNAL, cilt.31, sa.9, ss.2408-2414, 2022 (SCI-Expanded)
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 degrees and 31 degrees (p < 0.05) and L1S1 lordosis improved by 23 degrees and 32 degrees (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.