{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:29:30Z","timestamp":1781612970996,"version":"3.54.5"},"reference-count":71,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>To introduce and report early outcomes of an innovative surgical strategy to stabilize L5 PSOs with minimum 6 rods utilizing bilateral dual pelvic fixation consisting of both traditional iliac screws and osseointegrative S2AI screws.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Adult patients at a single institution who underwent a L5 PSO reconstructed with a minimum of 6 rods using dual pelvic fixation were reviewed. Accompanying a description of the surgical technique is patient demographics, perioperative sagittal radiographic alignment parameters, and early surgical and clinical outcomes, including incidences of mechanical complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Seven patients (4 females; average age 68\u2009\u00b1\u20098 years) met inclusion criteria. In addition to the L5 PSO, operative strategies were mixed [86% revisions, 86% lower thoracic UIV, 86% interbodies (ALIF, TLIF, DLIF) at either L3-4, L4-5, and\/or L5-S1]. Average L5 PSO angle was 34.1<jats:sup>0<\/jats:sup> \u00b1 3.2<jats:sup>0<\/jats:sup> (range, 30\u201339<jats:sup>0<\/jats:sup>), which resulted in significant improvements in all regional lumbopelvic and global sagittal alignment parameters. Final average post-operative regional sagittal alignments were within acceptable ranges (PT: 13.7<jats:sup>0<\/jats:sup>; L4-S1 lordosis: 45.9<jats:sup>0<\/jats:sup>; L1-S1 lordosis: 61.1<jats:sup>0<\/jats:sup>; PI-LL mismatch: 6.4<jats:sup>0<\/jats:sup>) as were global alignment metrics (C7-S1 SVA: 1.5; L1PA: 4.3<jats:sup>0<\/jats:sup>; T4PA: 7.1<jats:sup>0<\/jats:sup>; T4-L1 PA mismatch: 2.9<jats:sup>0<\/jats:sup>). At average follow-up of 17 months, no patients had rod breakages or pelvic screw failures. One patient required revision surgery to address proximal junctional kyphosis\/failure secondary to overcorrection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Bilateral dual pelvic fixation consisting of traditional iliac screws and osseointegrative S2AI screws to facilitate creation of \u201csuper\u201d multi-rod constructs (minimum 6 rods) across L5 PSOs is a safe surgical strategy with promising early clinical results. Larger cohorts from multiple centers with longer follow-up will aid in determining its long-term efficacy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00586-025-09274-1","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T01:19:27Z","timestamp":1755479967000},"page":"4260-4272","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stabilization of L5 pedicle Subtraction osteotomies (PSO) with \u2265\u20096-rods and bilateral dual pelvic fixation with osseointegrative implants: surgical technique description and early postoperative outcomes"],"prefix":"10.1007","volume":"34","author":[{"given":"Zachary","family":"Brumm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alekos A.","family":"Theologis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"issue":"3","key":"9274_CR1","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1007\/s00586-016-4859-8","volume":"26","author":"A Luca","year":"2017","unstructured":"Luca A, Ottardi C, Sasso M et al (2017) Instrumentation failure following pedicle subtraction osteotomy: the role of rod material, diameter, and multi-rod constructs. 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