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Proximal junctional kyphosis after adult spinal deformity operated patients with long fusion to the pelvis. Does the type of proximal anchor matter?
Bourghli, Anouar; Boissiere, Louis; Larrieu, Daniel; Pizones, Javier; Alanay, Ahmet; Pellisé, Ferran; Kleinstück, Frank; Obeid, Ibrahim.
Afiliación
  • Bourghli A; Spine Surgery Department, King Faisal Specialist Hospital and Research Centre, P.O.Box 3354, 11211, Riyadh, Saudi Arabia. Anouar.bourghli@gmail.com.
  • Boissiere L; Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
  • Larrieu D; Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
  • Pizones J; Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain.
  • Alanay A; Spine Surgery Unit, Acibadem Maslak Hospital, Istanbul, Turkey.
  • Pellisé F; Spine Surgery Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
  • Kleinstück F; Spine Center, Schulthess Klinik, Zurich, Switzerland.
  • Obeid I; Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
Eur Spine J ; 33(7): 2832-2839, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38844585
ABSTRACT

PURPOSE:

To assess, in a large population of Adult Spinal Deformity (ASD) patients, the true interest of varying the upper anchors as a protective measure against Proximal Junctional Kyphosis (PJK), by analyzing and comparing 2 groups of patients defined according to their proximal construct. Another objective of the study is to look for any other factors, radiological or clinical, that would affect the occurrence of the proximal failure.

METHODS:

Retrospective review of a prospective ASD database collected from 5 centers. Inclusion criteria were age of at least 18 years, presence of a spinal deformity with instrumentation from T12 or above to the pelvis, with minimum 2 years of follow-up. Demographic data, spinopelvic parameters, functional outcomes and complications were collected. Multiple logistic regression analysis was performed to identify the risk factors that would affect the occurrence of PJK.

RESULTS:

254 patients were included. 166 in the group "screws proximally" (SP) and 88 in the group "hooks proximally" (HP). There was no difference between both groups for PJK (p = 0.967). The occurrence of PJK was rather associated with greater age and BMI, higher preoperative kyphosis, worst preoperative SRS22 and SF36 scores, greater postoperative Sagittal Vertical Axis (SVA), coronal malalignment and kyphosis.

CONCLUSION:

The use of proximal hooks was not effective to prevent PJK after ASD surgery, when compared to proximal screws. Worse preoperative functional outcomes and worse postoperative sagittal and also coronal malalignment were the main drivers for the occurrence of PJK regardless the type of proximal implant.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Cifosis Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Cifosis Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Alemania