Multilevel Stabilization Screws Prevent Proximal Junctional Failure and Kyphosis in Adult Spinal Deformity Surgery: A Comparative Cohort Study
Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) occurred in up to 40% of patients with adult spinal deformity (ASD) who underwent open thoracolumbar fusion. Proximal stabilization techniques have been investigated to prevent PJK/PJF without conclusive results. To demonstrate...
Saved in:
Published in | Operative neurosurgery (Hagerstown, Md.) Vol. 22; no. 3; p. 150 |
---|---|
Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.03.2022
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) occurred in up to 40% of patients with adult spinal deformity (ASD) who underwent open thoracolumbar fusion. Proximal stabilization techniques have been investigated to prevent PJK/PJF without conclusive results.
To demonstrate reductions in PJK/PJF with multilevel stabilization screws (MLSSs).
This observational longitudinal cohort study compares MLSSs with standard instrumentation. We reviewed the charts of consecutive patients with ASD undergoing open thoracolumbar fusion (>3 levels, extending cranially above T6 and caudally below L1) from 2009 to 2017 and were followed for >2 yr postoperatively. We defined PJF using the International Spine Study Group criteria and PJK as a Cobb angle increase >10°. We defined the upper instrumented vertebra as the most cephalad vertebral body with bilateral MLSSs. Confounders, MLSS-specific complications, and radiographic outcomes were collected. We evaluated comparability between groups using univariate analyses. We adjusted for covariates by using multivariable regressions modeling PJF and PJK separately with a P-value < .00625 considered significant after the Bonferroni correction. Sensitivity analysis accounted for those lost to follow-up.
Seventy-six patients (50 MLSS vs 26 controls) were included. MLSS patients were significantly older (64.5 ± 8.9 vs 54.8 ± 19.9 yr, P = .024) and had significantly lower PJF incidence (10.0% vs 30.8%, P = .023) and less kyphosis (1.3° ± 5.3° vs 5.2° ± 6.3°, P = .014). Multivariable analysis demonstrated a significant independent association between MLSSs and decreased odds of PJF (odds ratio: 0.11, 0.02-0.53, P = .006). Perioperative complications did not significantly differ between cohorts.
MLSSs are safe and efficacious in reducing PJF/PJK in patients with ASD undergoing open thoracolumbar fusion. |
---|---|
AbstractList | Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) occurred in up to 40% of patients with adult spinal deformity (ASD) who underwent open thoracolumbar fusion. Proximal stabilization techniques have been investigated to prevent PJK/PJF without conclusive results.
To demonstrate reductions in PJK/PJF with multilevel stabilization screws (MLSSs).
This observational longitudinal cohort study compares MLSSs with standard instrumentation. We reviewed the charts of consecutive patients with ASD undergoing open thoracolumbar fusion (>3 levels, extending cranially above T6 and caudally below L1) from 2009 to 2017 and were followed for >2 yr postoperatively. We defined PJF using the International Spine Study Group criteria and PJK as a Cobb angle increase >10°. We defined the upper instrumented vertebra as the most cephalad vertebral body with bilateral MLSSs. Confounders, MLSS-specific complications, and radiographic outcomes were collected. We evaluated comparability between groups using univariate analyses. We adjusted for covariates by using multivariable regressions modeling PJF and PJK separately with a P-value < .00625 considered significant after the Bonferroni correction. Sensitivity analysis accounted for those lost to follow-up.
Seventy-six patients (50 MLSS vs 26 controls) were included. MLSS patients were significantly older (64.5 ± 8.9 vs 54.8 ± 19.9 yr, P = .024) and had significantly lower PJF incidence (10.0% vs 30.8%, P = .023) and less kyphosis (1.3° ± 5.3° vs 5.2° ± 6.3°, P = .014). Multivariable analysis demonstrated a significant independent association between MLSSs and decreased odds of PJF (odds ratio: 0.11, 0.02-0.53, P = .006). Perioperative complications did not significantly differ between cohorts.
MLSSs are safe and efficacious in reducing PJF/PJK in patients with ASD undergoing open thoracolumbar fusion. |
Author | Claus, Chad Soo, Teck-Mun Carr, Daniel Hanson, Connor Kaufmann, Ascher Tong, Doris Houseman, Clifford |
Author_xml | – sequence: 1 givenname: Ascher surname: Kaufmann fullname: Kaufmann, Ascher organization: Division of Neurosurgery, Ascension Providence Hospital, College of Human Medicine, Michigan State University, Southfield, Michigan, USA – sequence: 2 givenname: Chad surname: Claus fullname: Claus, Chad – sequence: 3 givenname: Doris surname: Tong fullname: Tong, Doris – sequence: 4 givenname: Connor surname: Hanson fullname: Hanson, Connor – sequence: 5 givenname: Daniel surname: Carr fullname: Carr, Daniel – sequence: 6 givenname: Clifford surname: Houseman fullname: Houseman, Clifford – sequence: 7 givenname: Teck-Mun surname: Soo fullname: Soo, Teck-Mun |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35030140$$D View this record in MEDLINE/PubMed |
BookMark | eNpVkE1OwzAQhS0EolB6A4R8gRT_JU7YVYXyVyhSYF05tkONkjhynEI4BGfGFbBgNu9p5tMbzRyD_cY2GoBTjKaYEH6-esyn6F_xZA8cEUpJxEiCRmDSdW-hjSmLEWeHYERjRBFm6Ah8PfSVN5Xe6grmXhSmMp_CG9vAXDr93sEnF2aND2o_TC0qeNc3cgcEuxCm6p2GolHwfmg3tjMdNA2cqRAK89bsoEtdWlcbP8C8d6_aDRdwBue2boULi7Y6-I11Afe9Gk7AQSmqTk9-dQxeFlfP85toubq-nc-WkaSI-4jxFOkESZ5KQZOsyIigWOJYp0qxgkiFy4QSlGUIK4ZKWbAiJgVXKk1jQgQjY3D2k9v2Ra3VunXhNjes_x5DvgHGGmkw |
CitedBy_id | crossref_primary_10_1016_j_semss_2022_100992 crossref_primary_10_3390_jcm13071829 crossref_primary_10_1016_j_bas_2024_102807 crossref_primary_10_1016_j_wneu_2022_02_063 crossref_primary_10_1016_j_nec_2023_06_004 |
ContentType | Journal Article |
Copyright | Copyright © Congress of Neurological Surgeons 2022. All rights reserved. |
Copyright_xml | – notice: Copyright © Congress of Neurological Surgeons 2022. All rights reserved. |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1227/ONS.0000000000000076 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
EISSN | 2332-4260 |
ExternalDocumentID | 35030140 |
Genre | Journal Article Observational Study |
GroupedDBID | 0R~ 48X 53G 7X7 AAAAV AAAXR AAGIX AAHPQ AAIQE AAPQZ AAQKA AARTV AASCR AASXQ AAVAP ABASU ABDIG ABJNI ABLJU ABUWG ABXVJ ACGFS ACILI ACOAL ACXJB ACXNZ ADBBV ADGZP ADHKW ADHPY ADRTK AEMDU AENEX AENZO AETBJ AEWNT AFDTB AFFZL AFKRA AFOFC AFUWQ AGINJ AHMBA AHOMT AHQNM AJNWD AJZMW ALIPV ALMA_UNASSIGNED_HOLDINGS AMNEI APIBT BAYMD BCRHZ BENPR BPHCQ BTRTY BVXVI BYPQX C45 CDBKE CGR CUY CVF DAKXR EBS ECM EEVPB EIF ENERS ERAAH EX3 FCALG FECEO FLUFQ FOEOM FOTVD FQBLK FYUFA GAUVT GJXCC HLJTE IAO IPNFZ KOP KSI MHKGH NOYVH NPM NTWIH O9- OBH ODMLO OVD PAFKI PEELM PQQKQ PROAC RIG RLZ ROX RUSNO TEORI TJX UKHRP YAYTL YKOAZ YXANX |
ID | FETCH-LOGICAL-c307t-4780e60c78ca369b92a31c15e8dd4b2cd1f63209901d40fcb4b52b7dd88522a42 |
IngestDate | Tue Aug 27 13:48:21 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 3 |
Language | English |
License | Copyright © Congress of Neurological Surgeons 2022. All rights reserved. |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c307t-4780e60c78ca369b92a31c15e8dd4b2cd1f63209901d40fcb4b52b7dd88522a42 |
PMID | 35030140 |
ParticipantIDs | pubmed_primary_35030140 |
PublicationCentury | 2000 |
PublicationDate | 2022-03-01 |
PublicationDateYYYYMMDD | 2022-03-01 |
PublicationDate_xml | – month: 03 year: 2022 text: 2022-03-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Operative neurosurgery (Hagerstown, Md.) |
PublicationTitleAlternate | Oper Neurosurg (Hagerstown) |
PublicationYear | 2022 |
SSID | ssj0001345074 |
Score | 2.25579 |
Snippet | Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) occurred in up to 40% of patients with adult spinal deformity (ASD) who underwent open... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 150 |
SubjectTerms | Adult Bone Screws Cohort Studies Genetic Diseases, X-Linked Humans Kyphosis - surgery Longitudinal Studies Microphthalmos Musculoskeletal Abnormalities Skin Abnormalities Spine |
Title | Multilevel Stabilization Screws Prevent Proximal Junctional Failure and Kyphosis in Adult Spinal Deformity Surgery: A Comparative Cohort Study |
URI | https://www.ncbi.nlm.nih.gov/pubmed/35030140 |
Volume | 22 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LT9tAEF4FKlVcKqq-aKGaQ2_Iqb27foRbBEURqOEQkLih9e5aRCKOFRKp7Y_oH-ufYvbheKGgPnywLG-ysjyfZ2dmZ74h5FOs0pJTpaMqpirilU4ikfIs4jqtFK5oXCvL9jnORhf85DK97PV-BVlLq2XZlz8erSv5H6niPZSrqZL9B8muJ8UbeI3yxTNKGM9_JWNbPXtj0n6M0WjSXF1RJX6xC1Re-56fyVQDfJvObO-uWvrg37GY3rSbB6ffm-u5YSYxwQ9DyLE_aWy3rCNtbFpjqE9c-XRbyN5Rhh_Or9GCt_mI93aIzxrtf-EoM93_jUE7MrQZaHM69_-r6gfRiFOxqma-b_Pw1gAqSCRaeToEobrYuFNVR_PF9LZTpm1Bm-2lvQgDG-gTrzO7-toqQMoYjQyDfqitKQ1QyQLVmzgC29-WBErNpvTZeOKoKteHazsToKSZWZiw1Lmdfx59QNTdDm2QjbwwynbsA0c23Mc4Wt7cF2_iM31-7Im2yPN2lgdujjV3zrfJC--nwNCB7iXp6foV-dkBDu4BDhzgwAMOWsBBBzjwgAMEHLSAg2kNFnDgAAdrwIEH3AEMIYAbOLiBhdtrcnH85fxwFPmGHpHEpWQZ8byIdRbLvJCCZYNyQAVLZJLqQileUqmSKmPUbtUqHley5GVKy1ypokA3QXD6hmzW81q_I1DJnKqMcV3EgidKFhIXmgFPKE6r5EDskLfu9V01jrXlqn2x758c-UC2OhzukmcVqgm9hzbnsvxopXkHu9WElg |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Multilevel+Stabilization+Screws+Prevent+Proximal+Junctional+Failure+and+Kyphosis+in+Adult+Spinal+Deformity+Surgery%3A+A+Comparative+Cohort+Study&rft.jtitle=Operative+neurosurgery+%28Hagerstown%2C+Md.%29&rft.au=Kaufmann%2C+Ascher&rft.au=Claus%2C+Chad&rft.au=Tong%2C+Doris&rft.au=Hanson%2C+Connor&rft.date=2022-03-01&rft.eissn=2332-4260&rft.volume=22&rft.issue=3&rft.spage=150&rft_id=info:doi/10.1227%2FONS.0000000000000076&rft_id=info%3Apmid%2F35030140&rft_id=info%3Apmid%2F35030140&rft.externalDocID=35030140 |