Abstract
STUDY DESIGN: A retrospective case series of patients treated surgically for degenerative lumbar scoliosis (DLS).
OBJECTIVE: To determine incidence and risk factors of progressive global thoracic kyphosis (pGTK) after surgery for DLS.
SUMMARY OF BACKGROUND DATA: Sagittal balance affects the surgical treatment of spinal deformity in adults. Little is known about the loss of sagittal balance due to pGTK, or about the risk factors for pGTK, after surgery for DLS.
METHODS: We reviewed records from a multicenter database of adults with DLS, treated with posterior spinal fusion. Inclusion required an age of 50 years or more at the time of surgery, an upper instrumented vertebra at T9 and below, more than 5 fused segments, and at least 2 years of follow-up. We included 73 patients with a mean age of 68.3 years (range, 51-77 yr) and a mean follow-up period of 3.6 years (range, 2-11 yr). Independent risk factors for pGTK were identified by logistic regression analysis.
RESULTS: Significant pGTK, defined as an increase in thoracic kyphosis of more than 10° from before surgery to the time of final follow-up, was observed in 41% of the patients. Loss of the sagittal vertical axis was larger in patients with pGTK than without (4.7 vs. 1.5 cm; P = 0.02). Risk analysis showed larger lumbar lordosis correction in patients with pGTK. Multivariate logistic regression analysis identified an age greater than 75 (odds ratio, 5.53; P = 0.02, 95% confidence interval [1.4-22.4]) and sacropelvic fusion (odds ratio = 2.66, P = 0.02, 95% confidence interval [1.5-11.1]) as independent risk factors for pGTK.
CONCLUSION: The pGTK incidence after surgery for DLS was 41%. Age, sacropelvic fusion, and a larger sagittal correction were identified as pGTK risk factors. Long-term follow-up will provide more data on the clinical impact of pGTK in elderly patients.3.
| Original language | English |
|---|---|
| Pages (from-to) | E521-E528 |
| Journal | Spine |
| Volume | 39 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2014 Apr 15 |
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ASJC Scopus subject areas
- Medicine(all)
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Factors affecting the postoperative progression of thoracic kyphosis in surgically treated adult patients with lumbar degenerative scoliosis. / Keio Spine Research Group.
In: Spine, Vol. 39, No. 8, 15.04.2014, p. E521-E528.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors affecting the postoperative progression of thoracic kyphosis in surgically treated adult patients with lumbar degenerative scoliosis
AU - Keio Spine Research Group
AU - Yagi, Mitsuru
AU - Hosogane, Naobumi
AU - Okada, Eijiro
AU - Watanabe, Koota
AU - Machida, Masafumi
AU - Tezuka, Masaki
AU - Matsumoto, Morio
AU - Asazuma, Takashi
PY - 2014/4/15
Y1 - 2014/4/15
N2 - STUDY DESIGN: A retrospective case series of patients treated surgically for degenerative lumbar scoliosis (DLS).OBJECTIVE: To determine incidence and risk factors of progressive global thoracic kyphosis (pGTK) after surgery for DLS.SUMMARY OF BACKGROUND DATA: Sagittal balance affects the surgical treatment of spinal deformity in adults. Little is known about the loss of sagittal balance due to pGTK, or about the risk factors for pGTK, after surgery for DLS.METHODS: We reviewed records from a multicenter database of adults with DLS, treated with posterior spinal fusion. Inclusion required an age of 50 years or more at the time of surgery, an upper instrumented vertebra at T9 and below, more than 5 fused segments, and at least 2 years of follow-up. We included 73 patients with a mean age of 68.3 years (range, 51-77 yr) and a mean follow-up period of 3.6 years (range, 2-11 yr). Independent risk factors for pGTK were identified by logistic regression analysis.RESULTS: Significant pGTK, defined as an increase in thoracic kyphosis of more than 10° from before surgery to the time of final follow-up, was observed in 41% of the patients. Loss of the sagittal vertical axis was larger in patients with pGTK than without (4.7 vs. 1.5 cm; P = 0.02). Risk analysis showed larger lumbar lordosis correction in patients with pGTK. Multivariate logistic regression analysis identified an age greater than 75 (odds ratio, 5.53; P = 0.02, 95% confidence interval [1.4-22.4]) and sacropelvic fusion (odds ratio = 2.66, P = 0.02, 95% confidence interval [1.5-11.1]) as independent risk factors for pGTK.CONCLUSION: The pGTK incidence after surgery for DLS was 41%. Age, sacropelvic fusion, and a larger sagittal correction were identified as pGTK risk factors. Long-term follow-up will provide more data on the clinical impact of pGTK in elderly patients.3.
AB - STUDY DESIGN: A retrospective case series of patients treated surgically for degenerative lumbar scoliosis (DLS).OBJECTIVE: To determine incidence and risk factors of progressive global thoracic kyphosis (pGTK) after surgery for DLS.SUMMARY OF BACKGROUND DATA: Sagittal balance affects the surgical treatment of spinal deformity in adults. Little is known about the loss of sagittal balance due to pGTK, or about the risk factors for pGTK, after surgery for DLS.METHODS: We reviewed records from a multicenter database of adults with DLS, treated with posterior spinal fusion. Inclusion required an age of 50 years or more at the time of surgery, an upper instrumented vertebra at T9 and below, more than 5 fused segments, and at least 2 years of follow-up. We included 73 patients with a mean age of 68.3 years (range, 51-77 yr) and a mean follow-up period of 3.6 years (range, 2-11 yr). Independent risk factors for pGTK were identified by logistic regression analysis.RESULTS: Significant pGTK, defined as an increase in thoracic kyphosis of more than 10° from before surgery to the time of final follow-up, was observed in 41% of the patients. Loss of the sagittal vertical axis was larger in patients with pGTK than without (4.7 vs. 1.5 cm; P = 0.02). Risk analysis showed larger lumbar lordosis correction in patients with pGTK. Multivariate logistic regression analysis identified an age greater than 75 (odds ratio, 5.53; P = 0.02, 95% confidence interval [1.4-22.4]) and sacropelvic fusion (odds ratio = 2.66, P = 0.02, 95% confidence interval [1.5-11.1]) as independent risk factors for pGTK.CONCLUSION: The pGTK incidence after surgery for DLS was 41%. Age, sacropelvic fusion, and a larger sagittal correction were identified as pGTK risk factors. Long-term follow-up will provide more data on the clinical impact of pGTK in elderly patients.3.
UR - http://www.scopus.com/inward/record.url?scp=84925545779&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925545779&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000000226
DO - 10.1097/BRS.0000000000000226
M3 - Article
C2 - 24480961
AN - SCOPUS:84893194356
VL - 39
SP - E521-E528
JO - Spine
JF - Spine
SN - 0362-2436
IS - 8
ER -