Rod fracture after multiple-rod technique for adult spinal deformity: a case report

• Published in: Nagoya journal of medical science Vol. 86; no. 1; pp. 135 - 141
• Main Authors: Yamauchi, Ippei, Nakashima, Hiroaki, Machino, Masaaki, Ito, Sadayuki, Segi, Naoki, Tauchi, Ryoji, Ohara, Tetsuya, Kawakami, Noriaki, Imagama, Shiro
• Format: Journal Article
• Language: English
• Published: Japan Nagoya University 01-02-2024
• Subjects: Adult; Aged; Case Report; Female; Humans; Lordosis; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Reoperation - methods; Retrospective Studies; Spinal Fusion; Treatment Outcome; revision surgery; multi-rod technique; adult spinal deformity; rod fracture; pseudarthrosis
• ISSN: 0027-7622; 2186-3326
• DOI: 10.18999/nagjms.86.1.135

Here we report the case of a 71-year-old woman who complained of lower back and left leg pain due to rod fracture following instrumented fusion using the lateral lumbar interbody fusion and multi-rod technique to treat adult spinal deformity. Radiographic images revealed bilateral rod fractures at L4-5 and pseudoarthrosis at L2-5; lower lumbar lordosis was minimal, but upper lumbar hyperlordosis was noted. The patient underwent revision surgery, which included posterior spinal instrument replacement, L3-4 and L4-5 lateral lumbar interbody fusion cage removal, and L4 vertebral body replacement via the anterior approach. This is a rare case of reoperation with the multi-rod technique. Revision surgery should be performed in consideration of the proportion of lumbar lordosis and anterior bony fusion as the posterior component is resected and bony fusion can only be achieved anteriorly.