Independent Risk Factors of Proximal Junctional Kyphosis with Vertebral Fracture After Spinal Long Fusion: Survivorship Analysis of Adult Spinal Deformity Surgery Patients

被引:1
作者
Katayanagi, Junya [1 ]
Konuma, Hiroki [1 ]
Yanase, Tsukasa [1 ]
Inose, Hiroyuki [1 ]
Tanaka, Tomoyuki [1 ]
Iida, Takahiro [2 ]
Morishita, Shingo [3 ]
Jinno, Tetsuya [1 ]
机构
[1] Dokkyo Med Univ, Saitama Med Ctr, Dept Orthoped Surg, Koshigaya, Saitama, Japan
[2] Teine Keijinkai Hosp, Dept Orthoped Surg, Sapporo, Hokkaido, Japan
[3] Tokyo Med & Dent Univ, Dept Orthoped Surg, Bunkyo City, Tokyo, Japan
关键词
Adult spinal deformity; Existing vertebral fracture; Osteoporosis; Proximal junctional fracture; Survivorship analysis; BONE-MINERAL DENSITY; OSTEOPOROSIS; FAILURE; TERIPARATIDE; PREVENTION; MANAGEMENT; OUTCOMES; WOMEN; DXA;
D O I
10.1016/j.wneu.2024.05.174
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
- OBJECTIVE: This study aimed to identify risk factors for postoperative proximal junctional kyphosis (PJK) with vertebral fracture in adult spinal deformity (ASD) patients. We performed a survival analysis considering various factors, including osteoporosis. - METHODS: This single-center retrospective study included 101 ASD patients (mean age: 67.2 years, mean follow-up: 8.1 years). We included patients aged double dagger 50 years with abnormal radiographic variables undergoing corrective long spinal fusion. The main outcome measure was PJK with vertebral fracture, analyzed based on patient data, radiographic measurements, sagittal parameters, bone mineral density, and osteoporosis medication. - RESULTS: PJK occurred in 37.6% of patients, with vertebral fracture type 2 accounting for 65% of these cases. Kaplan-Meier analysis indicated a median PJK-free survival time of 60.7 months. Existing vertebral fracture (grade 1 or higher or grade 2 or higher) was a significant risk factor for PJK with vertebral fracture, with hazard ratios of 4.58 and 5.61, respectively. The onset time of PJK with vertebral fracture was 1.5 months postoperatively, with44% of these cases occurring within 1 month and 64% within 2 months. - CONCLUSIONS: PJK with vertebral fracture affected 25% of ASD patients, emphasizing the importance of osteoporosis evaluation. Existing vertebral fracture emerged as a significant independent risk factor, surpassing bone mineral density. This study provides valuable insights for spine surgeons, highlighting the need to provide osteoporosis treatment and emphasize potential postoperative complications during discussions with patients.
引用
收藏
页码:E597 / E605
页数:9
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