@article{ASJ120529,
author = {Thomas J. Buell and Ricardo J. Fernandez-de Thomas and Justin S. Smith and Munish C. Gupta},
title = {Use of supplemental rods in long posterior sacropelvic fusions for adult spinal deformity},
journal = {AME Surgical Journal},
volume = {6},
number = {0},
year = {2026},
keywords = {},
abstract = {Operative treatment of adult spinal deformity (ASD) is associated with significant benefits despite high complication rates. A common complication after ASD surgery is rod fracture (RF)/pseudarthrosis (PA). Symptomatic RF/PA can result in substantial pain, disability, and loss of deformity correction, which may warrant revision surgery. Supplemental rod constructs likely began as an attempt to lower the risk of primary RF/PA associated with 3-column osteotomies. A classic example is Gupta’s satellite rod construct—the shorter satellite rods are deeply recessed and unattached to the primary rods to avoid significant bending and weakening of the primary rods. Since then, supplemental rods have been increasingly used for biomechanical support at other high stress locations susceptible to nonunion, which include multilevel posterior column osteotomies and the lumbosacral junction. The accessory rod is likely the most common supplemental rod given its ease of application—it can be attached to the primary rod with side connectors above and below the area of high biomechanical load. When attached distally to an iliac bolt, accessory rods are termed iliac accessory rods (distinct from kickstand rods) and have been shown to significantly lower the occurrence of primary RF. Other supplemental rods are used primarily for deformity correction. Examples include kickstand rod distraction for coronal correction and intercalary rod compression for construct-to-construct shortening and sagittal correction. The objective of this review was to describe current nomenclature for supplemental rods, and to review how supplemental rods may provide biomechanical reinforcement and facilitate ASD correction.},
issn = {2788-578X}, url = {https://asj.amegroups.org/article/view/120529}
}