Distal junctional failure after corrective surgery without pelvic fixation for thoracolumbar junctional kyphosis due to osteoporotic vertebral fracture

医学 后凸 外科 骨科手术 骨质疏松症 固定(群体遗传学) 射线照相术 内科学 人口 环境卫生
作者
Yoshifumi Kudo,Ichiro Okano,Tomoaki Toyone,Koji Kanzaki,Kazuyuki Segami,Naohiro Kawamura,Masaya Sekimizu,Hiroshi Maruyama,Ryo Yamamura,Chikara Hayakawa,Koki Tsuchiya,Soji Tani,Koji Ishikawa,Katsunori Inagaki
出处
期刊:Journal of Orthopaedic Science [Elsevier BV]
卷期号:29 (3): 781-787 被引量:2
标识
DOI:10.1016/j.jos.2023.03.002
摘要

Thoracolumbar junctional kyphosis (TLJK) due to osteoporotic vertebral fracture (OVF) negatively impacts patients' quality of life. The necessity of pelvic fixation in corrective surgery for TLJK due to OVF remains controversial. This study aimed to: 1) evaluate the surgical outcomes of major corrective surgery for thoracolumbar junctional kyphosis due to osteoporotic vertebral fracture, and 2) identify the risk factors for distal junctional failure to identify potential candidates for pelvic fixation.Patients who underwent surgical correction (fixed TLJK>40°, OVF located at T11-L2, the lowermost instrumented vertebra at or above L5) were included. Sagittal vertical axis, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis (L1-S1), local kyphosis, and lower lumbar lordosis (L4-S1) were assessed. Proximal and distal junctional kyphosis (P/DJK) and failures (P/DJF) were evaluated. Pre/postoperative spinopelvic parameters were compared between DJF and non-DJF patients.Thirty-one patients (mean age: 72.3 ± 7.9 years) were included. PJK was observed in five patients (16.1%), while DJK in 11 (35.5%). Twelve cases (38.7%) were categorized as failure. Among the patients with PJK, there was only one patient (20%) categorized as PJF and required an additional surgery. Contrary, all of eleven patients with DJK were categorized as DJF, among whom six (54.5%) required additional surgery for pelvic fixation. In comparisons between DJF and non-DJF patients, there was no significant difference in pre/postoperative LK (pre/post, p = 0.725, p = 0.950). However, statistically significant differences were observed in the following preoperative alignment parameters: SVA (p = 0.014), LL (p = 0.001), LLL (p = 0.006), PT (p = 0.003), and PI-LL (p < 0.001).Spinopelvic parameters, which represent the compensatory function of lumbar hyperlordosis and pelvic retroversion, have notable impacts on surgical outcomes in correction surgery for TLJK due to OVF. Surgeons should consider each patient's compensatory function when choosing a surgical approach.

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
溪风不渡完成签到 ,获得积分10
刚刚
刚刚
小马甲应助冷酷丹翠采纳,获得10
刚刚
超帅的月光完成签到 ,获得积分10
1秒前
小杨杨完成签到,获得积分10
1秒前
ghfg发布了新的文献求助10
1秒前
llll完成签到 ,获得积分10
1秒前
zxx5313491完成签到,获得积分10
1秒前
丶丶完成签到,获得积分10
2秒前
充电宝应助JIE采纳,获得10
2秒前
无聊的万天完成签到,获得积分10
2秒前
小白科研完成签到,获得积分10
2秒前
2秒前
3秒前
3秒前
3秒前
ypcsjj完成签到,获得积分10
3秒前
3秒前
hhhh完成签到,获得积分10
4秒前
4秒前
Fiona完成签到,获得积分10
5秒前
qwp完成签到,获得积分10
5秒前
msy完成签到,获得积分10
5秒前
wanwu完成签到,获得积分10
6秒前
缓慢的书蝶完成签到,获得积分10
6秒前
6秒前
李健应助Xiaoyu采纳,获得10
6秒前
zxx5313491发布了新的文献求助10
6秒前
ljw发布了新的文献求助10
6秒前
jify完成签到,获得积分10
6秒前
Ava应助淡然钢笔采纳,获得10
6秒前
7秒前
大意的酸奶完成签到,获得积分10
7秒前
7秒前
natuki完成签到,获得积分10
9秒前
lll发布了新的文献求助10
9秒前
10秒前
赵紫宏发布了新的文献求助150
10秒前
Plasmacas完成签到,获得积分10
10秒前
10秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
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 3968719
求助须知:如何正确求助?哪些是违规求助? 3513608
关于积分的说明 11168681
捐赠科研通 3248960
什么是DOI,文献DOI怎么找? 1794573
邀请新用户注册赠送积分活动 875194
科研通“疑难数据库(出版商)”最低求助积分说明 804716