Pedicle subtraction osteotomies offer similar sagittal correction rates and complication rates in the primary and revision surgical settings.
Investigators in a study published in the Spine Journal observed better lumbopelvic mismatch correction in patients who underwent primary pedicle subtraction osteotomy. Researchers conducted a multicenter, prospective study to compare the outcomes of 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 one-year outcomes.
A total of 421 patients were included, with 70 patients undergoing primary PSO and 351 patients undergoing revision PSO.
Here are four key facts:
1. At the one-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 percent) than the revision setting (57 percent).
2. Within the first year of PSO, the overall revision rate of primary surgeries was 4.3 percent and it was 7.4 percent for the revision surgeries.
3. Researchers found no statistically significant different in the complication rates for the two groups at six weeks postoperatively. The primary and revision PSO groups experienced overall complication rates of 24.3 percent and 31.9 percent, respectively.
4. In conclusion, 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.