A Systematic Review of Risk Factors Associated With Distal Junctional Failure in Adult Spinal Deformity Surgery

医学 入射(几何) 科克伦图书馆 系统回顾 梅德林 围手术期 后凸 相对风险 脊柱融合术 并发症 外科 荟萃分析 脊柱畸形 畸形 内科学 置信区间 射线照相术 法学 物理 光学 政治学
作者
Jake M. McDonnell,Daniel P. Ahern,Scott C. Wagner,Patrick B. Morrissey,I. David Kaye,Arjun S. Sebastian,Joseph S. Butler
出处
期刊:Clinical spine surgery [Lippincott Williams & Wilkins]
卷期号:34 (9): 347-354 被引量:8
标识
DOI:10.1097/bsd.0000000000001224
摘要

The surgical management of adult spinal deformity (ASD) is a major surgical undertaking associated with considerable perioperative risk and a substantial complication profile. Although the natural history and risk factors associated with proximal junctional kyphosis (PJK) and proximal junctional failure are widely reported, distal junctional failure (DJF) is less well understood.A systematic review was carried out.The primary objective is to identify the risk factors associated with DJF. The secondary objective is to delineate the incidence rate and causative factors associated with DJF.A systematic review of articles in Medline/PubMed and The Cochrane Library databases was performed according to preferred reporting items for systematic reviews and meta-analyses guidelines. Data was collated to determine the prevalence of DJF and overall revision rates, and identify potential risk factors for development of DJF.Twelve studies were included for systematic review. There were 81/2261 (3.6%) cases of DJF. Overall, DJF represented 27.3% of all revision surgeries. Anterior-posterior surgery had a reduced incidence of postoperative DJF [5.0% vs. 8.7%; P=0.08; relative risk (RR)=1.73], as did patients below 60 years of age at the time of surgery (2.9% vs. 3.9%; P=0.09; RR=1.34). There was a higher incidence of DJF among those patients who received interbody fusion (9.9% vs. 5.1%; P=0.06; RR=1.93) compared with those who did not. However, none of these findings reached statistical significance. There were significantly more rates of DJF for fusions ending on L5 compared with constructs fused to the sacrum (11.7% vs. 3.6%; P=0.02; RR=3.28).Cohorts 60 years and above of age at the time of surgery and patients managed with posterior-only fusion or interbody fusion have increased incidences of DJF. Fusion to L5 instead of the sacrum significantly influences DJF rates. However, the quality of available evidence is low and further high-quality studies are required to more robustly analyze the clinical, radiographic, and surgical risk factors associated with the development of DJF after ASD surgery.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
李安全完成签到,获得积分10
刚刚
llliu发布了新的文献求助10
1秒前
轻松的亦寒应助肉肉采纳,获得20
1秒前
星辰大海应助鞥枊采纳,获得10
2秒前
3秒前
小二郎应助腼腆的绝山采纳,获得10
3秒前
4秒前
4秒前
4秒前
5秒前
123发布了新的文献求助10
6秒前
6秒前
小杰完成签到 ,获得积分10
8秒前
晗月完成签到,获得积分10
8秒前
via完成签到,获得积分10
9秒前
9秒前
wtt发布了新的文献求助10
9秒前
10秒前
ky一下完成签到,获得积分10
10秒前
笔墨留香发布了新的文献求助10
11秒前
谦让的巨人完成签到,获得积分20
12秒前
13秒前
15秒前
15秒前
鞥枊发布了新的文献求助10
16秒前
17秒前
17秒前
gabee完成签到 ,获得积分10
17秒前
ymx发布了新的文献求助10
18秒前
19秒前
20秒前
清秀的代珊完成签到,获得积分20
20秒前
格林渥发布了新的文献求助10
21秒前
21秒前
yxy发布了新的文献求助10
22秒前
蓓蓓完成签到 ,获得积分20
22秒前
22秒前
23秒前
24秒前
鞥枊完成签到,获得积分10
24秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3975658
求助须知:如何正确求助?哪些是违规求助? 3519986
关于积分的说明 11200481
捐赠科研通 3256410
什么是DOI,文献DOI怎么找? 1798247
邀请新用户注册赠送积分活动 877490
科研通“疑难数据库(出版商)”最低求助积分说明 806376