The effect of prophylactic vertebroplasty on the incidence of proximal junctional kyphosis and proximal junctional failure following posterior spinal fusion in adult spinal deformity: a 5-year follow-up study

医学 后凸 Oswestry残疾指数 脊柱融合术 外科 背景(考古学) 冠状面 矢状面 前瞻性队列研究 骨科手术 脊柱畸形 射线照相术 入射(几何) 队列 脊柱侧凸 畸形 腰痛 放射科 内科学 病理 古生物学 替代医学 物理 光学 生物
作者
Tina Raman,Emily Miller,Christopher T. Martin,Khaled M. Kebaish
出处
期刊:The Spine Journal [Elsevier]
卷期号:17 (10): 1489-1498 被引量:91
标识
DOI:10.1016/j.spinee.2017.05.017
摘要

Abstract

Background Context

The incidence of proximal junctional kyphosis (PJK) ranges from 5% to 46% following adult spinal deformity surgery. Approximately 66% to 76% of PJK occurs within 3 months of surgery. A subset of these patients, reportedly 26% to 47%, develop proximal junctional failure (PJF) within 6 months postoperatively. To date, there are no studies evaluating the impact of prophylactic vertebroplasty on PJK and PJF incidence at long-term follow-up.

Purpose

The purpose of this study is to evaluate the long-term radiographic and clinical outcomes, and incidence of PJK and PJF, after prophylactic vertebroplasty for long-segment thoracolumbar posterior spinal fusion (PSF).

Study Design

This is a prospective cohort study.

Patient Sample

Thirty-nine patients, of whom 87% were female, who underwent two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF were included in this study.

Outcome Measures

Clinical outcomes were assessed using the Scoliosis Research Society-22 (SRS-22), and Short-Form (SF) 36 questionnaires, and the Oswestry Disability Index (ODI). Radiographic parameters including PJK angle, and coronal and sagittal alignment, were calculated, along with relevant perioperative complications and revision rates.

Methods

Of the 41 patients who received two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF, and comprised a cohort with previously published 2-year follow-up data, 39 (95%) completed 5-year follow-up (average: 67.6 months). Proximal junctional kyphosis was defined as a change in the PJK angle ≥10° between the immediate postoperative and final follow-up radiograph. Proximal junctional failure was defined as acute proximal junctional fracture, fixation failure, or kyphosis requiring extension of fusion within the first 6 months postoperatively.

Results

Thirty-nine patients with a mean age of 65.6 (41–87) years were included in this study. Of the 39 patients, 28.2% developed PJK (11: 7.7% at 2 years, 20.5% between 2 and 5 years), and 5.1% developed acute PJF. Two of the 11 PJK patients required revision for progressive worsening of the PJK. There were no proximal junctional fractures. There was no significant difference in preoperative, immediate postoperative, and final follow-up measurements of thoracic kyphosis, lumbar lordosis, and coronal or sagittal alignment between patients who developed PJK, PJF, or neither (p>.05). There was no significant difference in ODI, SRS-22, or SF-36 scores between those with and without PJK or PJF (p>.05).

Conclusions

This long-term follow-up demonstrates that prophylactic vertebroplasty may minimize the risk for junctional failure in the early postoperative period. However, it does not appear to decrease the incidence of PJK at 5 years.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

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
777发布了新的文献求助10
刚刚
meng完成签到 ,获得积分10
刚刚
lilylwy完成签到 ,获得积分10
3秒前
彭于晏应助Singularity采纳,获得10
5秒前
11秒前
zl发布了新的文献求助10
14秒前
zwzxtx完成签到 ,获得积分10
17秒前
自信放光芒~完成签到 ,获得积分10
20秒前
科研通AI2S应助zl采纳,获得10
22秒前
科研通AI2S应助banimadao采纳,获得10
23秒前
坚强的铅笔完成签到 ,获得积分10
27秒前
Leonardi完成签到,获得积分0
31秒前
Telomere完成签到 ,获得积分10
36秒前
banimadao完成签到,获得积分10
47秒前
amar完成签到 ,获得积分0
49秒前
herpes完成签到 ,获得积分0
53秒前
李荷花完成签到 ,获得积分10
56秒前
郑志凡完成签到 ,获得积分10
1分钟前
千秋完成签到 ,获得积分10
1分钟前
qcck完成签到 ,获得积分10
1分钟前
丘比特应助kylin采纳,获得100
1分钟前
哈哈完成签到,获得积分10
1分钟前
popo6150完成签到,获得积分10
1分钟前
平常从蓉应助明理问柳采纳,获得10
1分钟前
乐乐应助哈哈采纳,获得10
1分钟前
1分钟前
wangeil007完成签到,获得积分10
1分钟前
研友_8KXkJL完成签到 ,获得积分10
1分钟前
叶远望完成签到 ,获得积分10
1分钟前
Singularity发布了新的文献求助10
1分钟前
只喝白开水完成签到 ,获得积分10
1分钟前
文静的电灯胆完成签到,获得积分10
2分钟前
njseu完成签到 ,获得积分10
2分钟前
2分钟前
月亮完成签到 ,获得积分10
2分钟前
Singularity发布了新的文献求助10
2分钟前
TEY完成签到 ,获得积分10
2分钟前
guang5210完成签到,获得积分10
2分钟前
www完成签到 ,获得积分10
2分钟前
周周完成签到 ,获得积分10
3分钟前
高分求助中
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Le dégorgement réflexe des Acridiens 800
Defense against predation 800
XAFS for Everyone (2nd Edition) 600
热门求助领域 (近24小时)
化学 医学 生物 材料科学 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 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3134020
求助须知:如何正确求助?哪些是违规求助? 2784845
关于积分的说明 7768824
捐赠科研通 2440241
什么是DOI,文献DOI怎么找? 1297353
科研通“疑难数据库(出版商)”最低求助积分说明 624928
版权声明 600792