Influencing factors of proximal junctional kyphosis in adult scoliosis patients after surgery / 第二军医大学学报

ABSTRACT

Objective To measure the spinal sagittal parameters and pelvic parameters of adult scoliosis patients, and to explore the influencing factors of proximal junctional kyphosis (PJK) after surgery. Methods The clinical data of 45 adult scoliosis patients, who underwent surgical treatment in our hospital from Jan. 2014 to Sep. 2016, were retrospectively analyzed. The participants were divided into PJK group and non-PJK group according to whether proximal junctional angle (PJA) was >20°. Before operation, at 1 week after operation and at the last follow-up, the thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) were measured and analyzed on the anteroposterior and lateral X-ray films of the spine. The main influencing factors of PJK in adult scoliosis patients after surgery were analyzed using logistic multivariate regression analysis. Results Nineteen patients were enrolled in the PJK group and 26 in the non-PJK group. There were no significant differences in the gender, age, followup time, upper instrumented vertebra or lower instrumented vertebra between the two groups (all P>0.05). Compared with the non-PJK group, the LL, SVA and PT at the last follow-up, and PT before operation were significantly larger in the PJK group, and the SS before operation and at the last follow-up were significantly lower (all P0.05). Logistic multivariate regression analysis showed that TK and SS before operation, and TK, LL and PT at the last follow-up were the main influencing factors of PJK. Conclusion TK and SS before operation, and TK, LL and PT at the last follow-up are the main influencing factors of PJK.