| Popis: |
BACKGROUND CONTEXT PJK has been well documented with pedicle screws in AIS patients. In Scheurmann's kyphosis (SK), PJK has been reported with hybrid fixation in the presence of shorter fusion. The literature is deficient about PJK in SK with all pedicle screw constructs. PURPOSE To find the incidence of PJK in SK with different instrumentation types. STUDY DESIGN/SETTING Ambispective Review. PATIENT SAMPLE A total of 84 SK patients that were corrected with either pedicle screws (PS), hybrid fixation (HF) or anterior/posterior fusions with hybrid fixation (AP). OUTCOME MEASURES Number of fusion levels, percent correction, UIV, LIV, pre- and postoperative PJK, sagittal balance and demographic data. PJK was definded as more than 10 degrees. METHODS X-ray and chart review of all SK patients operated with all pedicle screws (PS), hybrid fixation (HF) and anterior/posterior fusions with hybrid fixation (AP) were reviewed. Number of fusions levels, percent correction, UIV, LIV, pre- and postoperative PJK, sagittal balance and demographic data was collected. PJK was defined as more than 10 degrees. Fisher's exact testm Kruskal-Wallis, Wilcoxon ranked sum test were used. RESULTS Eighty-four total patients: PS (n=29), HF (n =24), and AP (n=31). Median preoperative kyphosis was higher in the AP compared to PS and HF (89 vs 77 vs 81.5, p 0.05). Overall, at postoperative 47.6% of patients had PJK, and at final 70.2%. Immediate postoperative -PJK was significantly higher in PS (13.4 vs HF:15 vs AP 14, p =0.07). T2 was the most common UIV for AP (71%) and HF (71%) compared to T3 for PS (59%) (p CONCLUSIONS Incidence of PJK appears to be higher in SK compared to that reported in AIS. Patients with pedicle screw fixation appear to be at the highest risk. UIV at T3 or proximally has significantly lower PJK. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. |
Full Text from ScienceDirect