Surgical Correction in Patients with Lumbar Degenerative Kyphosis Who Had Low Bone Mineral Density: An Analysis of 40 Patients with a Minimum Follow-Up of Two Years
Asian Spine Journal
;
: 65-74, 2015.
Article
in English
| WPRIM
| ID: wpr-185078
ABSTRACT
STUDY DESIGN:
Retrospective study.PURPOSE:
To investigate influence of bone mineral density (BMD) on the surgical correction of lumbar degenerative kyphosis (LDK). OVERVIEW OF LITERATURE No studies so far have reported the influence of BMD on the surgical correction of LDK.METHODS:
Forty LDK patients with more than 2 years follow-up were studied. Pelvic incidence (PI), pelvic tilt, sacral slope, sagittal vertical axis (SVA), lumbar lordosis (LL), and thoracic kyphosis were measured preoperatively, immediate postoperatively and at final follow-up. Adverseoutcomes:
proximal adjacent fractures, sagittal decompensation, pseudoarthrosis, and cage subsidence were documented.RESULTS:
There were 37 females and 3 males. Average age was 65.1+/-4.5 years and mean follow-up was 34.2+/-16.7 months. 42.5% were Takemitsu type 3 curves, 27.5% type 2, 20.0% type 4 and 10.0% type 1. 37.5% had osteopenia, 40.0% osteoporosis and 22.5% had severe osteoporosis. SVA improved from 237.0+/-96.7 mm preoperatively to 45.3+/-41.8 mm postoperatively (p=0.000). LL improved from 10.5degrees+/-14.7degrees to -40.6degrees+/-10.9degrees postoperatively (p=0.000). At final follow-up SVA deteriorated to 89.8+/-72.2 mm and LL to 34.7degrees+/-15.8degrees (p=0.000). The association between late sagittal decompensation, pseudoarthrosis, or proximal adjacent fractures and osteoporosis was insignificant. The difference between immediate postoperative LL and PI (PIDiff) had a significant association with sagittal decompensation and pseudoarthrosis.CONCLUSIONS:
Osteoporosis did not influence the degree of correction, late sagittal decompensation, proximal adjacent fractures, and pseudoarthrosis in LDK. PIDiff had a significant association with sagittal decompensation and pseudoarthrosis.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osteoporosis
/
Pseudarthrosis
/
Axis, Cervical Vertebra
/
Bone Diseases, Metabolic
/
Bone Density
/
Incidence
/
Retrospective Studies
/
Follow-Up Studies
/
Kyphosis
/
Lordosis
Type of study:
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Animals
/
Female
/
Humans
/
Male
Language:
English
Journal:
Asian Spine Journal
Year:
2015
Type:
Article
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