Outcomes of Non-Operative Management for Pseudarthrosis after Pedicle Subtraction Osteotomies at Minimum 5 Years Follow-Up
Journal of Korean Neurosurgical Society
;
: 567-576, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-788805
ABSTRACT
OBJECTIVE:
Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection.METHODS:
Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5–10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed.RESULTS:
Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05).CONCLUSION:
Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Osteotomia
/
Pseudoartrose
/
Escoliose
/
Coluna Vertebral
/
Braquetes
/
Saúde Mental
/
Seguimentos
/
Deformidades Articulares Adquiridas
/
Cifose
/
Lordose
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Animais
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2019
Tipo de documento:
Artigo
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