Fei Xu1,2,3,4, Zhuoran Sun1,3,4, Weishi Li5,6,7, Xiangyu Hou1,2,4, Shuai Jiang1,3,4, Siyu Zhou1,3,4, Da Zou1,3,4, Zhuofu Li1,2,3,4. 1. Orthopaedic Department, Peking University Third Hospital, Haidian District, No. 49 North Garden Road, Beijing, 100191, China. 2. Peking University Health Science Center, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China. 3. Beijing Key Laboratory of Spinal Disease Reasearch, Beijing, China. 4. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China. 5. Orthopaedic Department, Peking University Third Hospital, Haidian District, No. 49 North Garden Road, Beijing, 100191, China. puh3liweishi@163.com. 6. Beijing Key Laboratory of Spinal Disease Reasearch, Beijing, China. puh3liweishi@163.com. 7. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China. puh3liweishi@163.com.
Abstract
PURPOSE: This study aimed to evaluate the effect of postoperative reciprocal progression of Lordosis tilt (LT), Lordosis distribution index (LDI) and occurrence of Proximal junctional kyphosis (PJK) following surgery for Degenerative lumbar scoliosis (DLS). METHODS: A total of 122 consecutive patients with ADS were treated with correction of deformity and followed up for a minimum of 2 years. Spinopelvic parameters were measured preoperatively, postoperatively, and at the latest follow-up. The Japanese Orthopaedic Association score, Oswestry Disability Index, and visual analog scale scores were measured at the latest follow-up. Associations between LT, LDI, and PJK were analyzed using receiver operating characteristic analyses. RESULTS: The prevalence of PJK in the present study was 24.6%. The outcomes of patients with PJK were significantly worse than those of patients without PJK. Postoperative reciprocal progression in LT and LDI with lumbar lordosis restorative surgery was observed. Preoperative risk factors for PJK were older age, larger LT, and larger Cobb angle of the curves. Postoperative risk factors for PJK included postoperative LT and postoperative Cobb angle of the curves, which were smaller than those preoperatively. We found a strong correlation between postoperative LT and Cobb angle of the curves resulting in PJK. Patients with LT < - 8° were at a higher risk of PJK. CONCLUSIONS: LT can be used to predict the occurrence of PJK in patients undergoing surgery for DLS. Appropriate postoperative LT is crucial for preventing the progression of PJK.
PURPOSE: This study aimed to evaluate the effect of postoperative reciprocal progression of Lordosis tilt (LT), Lordosis distribution index (LDI) and occurrence of Proximal junctional kyphosis (PJK) following surgery for Degenerative lumbar scoliosis (DLS). METHODS: A total of 122 consecutive patients with ADS were treated with correction of deformity and followed up for a minimum of 2 years. Spinopelvic parameters were measured preoperatively, postoperatively, and at the latest follow-up. The Japanese Orthopaedic Association score, Oswestry Disability Index, and visual analog scale scores were measured at the latest follow-up. Associations between LT, LDI, and PJK were analyzed using receiver operating characteristic analyses. RESULTS: The prevalence of PJK in the present study was 24.6%. The outcomes of patients with PJK were significantly worse than those of patients without PJK. Postoperative reciprocal progression in LT and LDI with lumbar lordosis restorative surgery was observed. Preoperative risk factors for PJK were older age, larger LT, and larger Cobb angle of the curves. Postoperative risk factors for PJK included postoperative LT and postoperative Cobb angle of the curves, which were smaller than those preoperatively. We found a strong correlation between postoperative LT and Cobb angle of the curves resulting in PJK. Patients with LT < - 8° were at a higher risk of PJK. CONCLUSIONS: LT can be used to predict the occurrence of PJK in patients undergoing surgery for DLS. Appropriate postoperative LT is crucial for preventing the progression of PJK.
Authors: Ferran Pellisé; Alba Vila-Casademunt; Montse Ferrer; Montse Domingo-Sàbat; Juan Bagó; Francisco J S Pérez-Grueso; Ahmet Alanay; A F Mannion; Emre Acaroglu Journal: Eur Spine J Date: 2014-09-14 Impact factor: 3.134
Authors: Caglar Yilgor; Nuray Sogunmez; Louis Boissiere; Yasemin Yavuz; Ibrahim Obeid; Frank Kleinstück; Francisco Javier Sánchez Pérez-Grueso; Emre Acaroglu; Sleiman Haddad; Anne F Mannion; Ferran Pellise; Ahmet Alanay Journal: J Bone Joint Surg Am Date: 2017-10-04 Impact factor: 5.284