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
晶晶发布了新的文献求助30
刚刚
科研通AI2S应助芜湖采纳,获得10
1秒前
阿蒙发布了新的文献求助10
1秒前
1秒前
jcf完成签到 ,获得积分10
2秒前
阿依努尔发布了新的文献求助10
2秒前
JamesPei应助Rain采纳,获得10
2秒前
咏君应助五梁液采纳,获得30
3秒前
3秒前
聪明汉堡完成签到,获得积分10
4秒前
人生如梦完成签到,获得积分10
4秒前
kk完成签到,获得积分10
4秒前
果泥完成签到,获得积分10
5秒前
汉堡包应助如意的代真采纳,获得10
5秒前
脑洞疼应助晶晶采纳,获得10
5秒前
pkubest完成签到,获得积分10
5秒前
5秒前
zhao完成签到,获得积分10
5秒前
王sir发布了新的文献求助10
5秒前
6秒前
6秒前
6秒前
6秒前
andrewyu发布了新的文献求助30
7秒前
清爽山雁完成签到 ,获得积分10
8秒前
13201099463发布了新的文献求助30
8秒前
缥缈向松发布了新的文献求助10
8秒前
8秒前
SciGPT应助Beginner采纳,获得10
8秒前
论太刀虾发布了新的文献求助10
9秒前
Xenia发布了新的文献求助10
9秒前
DDd完成签到 ,获得积分10
10秒前
liyunma发布了新的文献求助10
10秒前
亮亮发布了新的文献求助10
10秒前
潇洒的尔风完成签到 ,获得积分10
12秒前
13秒前
可爱的函函应助七安采纳,获得10
13秒前
王晓曼完成签到,获得积分20
14秒前
15秒前
15秒前
高分求助中
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
Effective Learning and Mental Wellbeing 300
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 3974779
求助须知:如何正确求助?哪些是违规求助? 3519193
关于积分的说明 11197417
捐赠科研通 3255311
什么是DOI,文献DOI怎么找? 1797760
邀请新用户注册赠送积分活动 877150
科研通“疑难数据库(出版商)”最低求助积分说明 806187