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Purpose <p>While 3-column osteotomy (3-CO) is associated with high reoperation and complication rates, long-term outcomes remain unreported. Evaluating long-term outcomes after adult spinal deformity (ASD) surgery with 3-CO is crucial to improving clinical management. In this study, we investigated 10-year postoperative outcomes of corrective fusion surgery with 3-CO in adult patients with spinal deformities, focusing on alignment changes, patient-reported outcomes, and reoperation incidence.</p> Methods <p>Data were retrospectively retrieved from a single-center database of ASD surgeries. This retrospective case series included 84 patients (73 women) who underwent posterior 3-CO fusion for ASD between 2010 and 2014. Spinopelvic parameters were measured using standing whole-spine radiographs obtained from the preoperative period through 10 years postoperatively. Patient-reported outcomes were assessed at the same intervals. Surgical details, complications, and reoperations were recorded.</p> Results <p>The mean age at surgery was 67.1 years. Among 49 patients with follow-up beyond 10 years, all radiographic parameters significantly improved postoperatively, although the pelvic tilt, thoracic kyphosis, and sagittal vertical axis progressively increased over time. The Oswestry Disability Index (%) improved significantly from 45.7 preoperatively to 31.2 at 2 years, 29.0 at 5 years, and 28.4 at 10 years, showing sustained benefit. The most frequent perioperative complication was postoperative delirium, observed in 10 patients. Reoperation was required in 41 patients (52.4%) for a total of 54 procedures.</p> Conclusion <p>Ten-year outcomes of adult patients with spinal deformities treated with 3-CO fusion were relatively favorable. Global alignment improved postoperatively but gradually declined, while patient-reported outcomes improved and were maintained for 10 years.</p>

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Ten-year follow-up report of corrective fusion with 3-column osteotomy in adult patients with spinal deformities: a retrospective case series

  • 期刊论文

  • 发表日期：

    2025年10月17日

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  • Yu Yamato,
  • Tomohiko Hasaegawa,
  • Go Yoshida,
  • Tomohiro Banno,
  • Hideyuki Arima,
  • Shin Oe,
  • Koichiro Ide,
  • Tomohiro Yamada,
  • Kenta Kurosu,
  • Yusuke Murakami,
  • Yukihiro Matsuyama

摘要

Purpose

While 3-column osteotomy (3-CO) is associated with high reoperation and complication rates, long-term outcomes remain unreported. Evaluating long-term outcomes after adult spinal deformity (ASD) surgery with 3-CO is crucial to improving clinical management. In this study, we investigated 10-year postoperative outcomes of corrective fusion surgery with 3-CO in adult patients with spinal deformities, focusing on alignment changes, patient-reported outcomes, and reoperation incidence.

Methods

Data were retrospectively retrieved from a single-center database of ASD surgeries. This retrospective case series included 84 patients (73 women) who underwent posterior 3-CO fusion for ASD between 2010 and 2014. Spinopelvic parameters were measured using standing whole-spine radiographs obtained from the preoperative period through 10 years postoperatively. Patient-reported outcomes were assessed at the same intervals. Surgical details, complications, and reoperations were recorded.

Results

The mean age at surgery was 67.1 years. Among 49 patients with follow-up beyond 10 years, all radiographic parameters significantly improved postoperatively, although the pelvic tilt, thoracic kyphosis, and sagittal vertical axis progressively increased over time. The Oswestry Disability Index (%) improved significantly from 45.7 preoperatively to 31.2 at 2 years, 29.0 at 5 years, and 28.4 at 10 years, showing sustained benefit. The most frequent perioperative complication was postoperative delirium, observed in 10 patients. Reoperation was required in 41 patients (52.4%) for a total of 54 procedures.

Conclusion

Ten-year outcomes of adult patients with spinal deformities treated with 3-CO fusion were relatively favorable. Global alignment improved postoperatively but gradually declined, while patient-reported outcomes improved and were maintained for 10 years.