{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:31:52Z","timestamp":1783477912644,"version":"3.55.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"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":["Spine Deform"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Despite standardized biomechanical tests for spinal implants, we recently recognized pedicle screw failure to maintain the rod fixated as a clinical concern in scoliosis surgery. This occurrence study investigates the risk and magnitude of axial rod slip (ARS), its relation with technique and preventive measures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective multicenter review of all primary scoliosis cases (2018\u20132020) with\u2009&gt;\u20091\u00a0year FU from three centers, instrumented with uniplanar screws and 5.5\u00a0mm CoCr rods (Mesa 2, Stryker Corporation, Kalamazoo, MI, USA). ARS was defined as\u2009&gt;\u20091\u00a0mm change in residual distal rod length from the screw in the lowest instrumented vertebra (LIV) and assessed by two independent observers. Slip distance, direction, relation to distal screw density and time of observation were recorded, as well as the effect of ARS on caudal curve increase. To prevent slip, more recent patients were instrumented with a different end-of-construct screw (Reline, NuVasive Inc. San Diego, CA, USA) and analyzed for comparison.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>ARS risk was 27% (56\/205) with a distance of 3.6\u2009\u00b1\u20092.2\u00a0mm, predominantly convex. 42% occurred before 4\u00a0months, the rest before 1 year. The caudal curve substantially increased three times more often in patients with ARS. Interobserver reliability was high and slip was in the expected direction. ARS was unrelated to distal screw density. Remarkable variation in ARS rates (53%, 31%, 13%) existed between the centers, while there was no difference in mean screw density (\u22481.3 screws\/level) or curve correction (\u224860%). Revision surgery for ARS was required in 2.9% (6\/207). Using the different end-of-construct screw, ARS risk was only 2% (1\/56) and no revisions were required.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study demonstrates the prevalence of axial rod slip at the end of construct in scoliosis surgery and its clinical relevance. While minimal ARS can be subclinical, ARS should not be mistaken for adding on. The most severe ARS predominantly occurred convex at the high-loaded distal screw when L3 was the LIV. Longer constructs (LIV L3 or L4) have a higher risk of ARS. The minimal risk of ARS with another end-of-construct screw underscores the influence of screw type on ARS occurrence in our series. Further research is essential to refine techniques and enhance patient outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-024-00925-9","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T07:18:22Z","timestamp":1724311102000},"page":"1699-1707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Axial rod slip at the end-of-construct screw in scoliosis surgery: relevance, occurrence and prevention"],"prefix":"10.1007","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1517-5914","authenticated-orcid":false,"given":"T. P.","family":"Schl\u00f6sser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Blaauw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"van der Valk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"van Solinge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Faber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Kruyt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"925_CR1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.2106\/00004623-196244040-00001","volume":"44-A","author":"PR Harrington","year":"1962","unstructured":"Harrington PR (1962) Treatment of scoliosis. correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 44-A:591\u2013610","journal-title":"J Bone Joint Surg Am"},{"key":"925_CR2","first-page":"489","volume":"70","author":"Y Cotrel","year":"1984","unstructured":"Cotrel Y, Dubousset J (1984) A new technic for segmental spinal osteosynthesis using the posterior approach. Rev Chir Orthop Reparatrice Appar Mot 70:489\u2013494","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"78","key":"925_CR3","first-page":"1447","volume":"1970","author":"R Roy-Camille","year":"1893","unstructured":"Roy-Camille R, Roy-Camille M, Demeulenaere C (1893) Osteosynthesis of dorsal, lumbar, and lumbosacral spine with metallic plates screwed into vertebral pedicles and articular apophyses. 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