Ideal sagittal profile restoration and ideal lumbar apex positioning play an important role in postoperative mechanical complications after a lumbar PSO
| Autor: | Frank Kleinstück, Ibrahim Obeid, Javier Pizones, Ahmet Alanay, Nicomedes Fernández-Baíllo, Alba Vila-Casademunt, Emre Acaroglu, José Miguel Sánchez-Márquez, Lucía Moreno-Manzanaro, Ferran Pellisé, Louis Boissiere, Caglar Yilgor, Francisco Javier Sánchez Pérez-Grueso, Gloria Talavera |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Lordosis medicine.medical_treatment Osteotomy 03 medical and health sciences Postoperative Complications 0302 clinical medicine Lumbar Pedicle Screws Risk Factors medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies 030222 orthopedics Univariate analysis Lumbar Vertebrae business.industry Bone Malalignment Middle Aged medicine.disease Sagittal plane Vertebra Apex (geometry) Surgery medicine.anatomical_structure Orthopedic surgery Female Spinal Diseases business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Spine Deformity. 8:491-498 |
| ISSN: | 2212-1358 2212-134X |
| Popis: | Retrospective analysis of prospectively collected data. To determine the influence of postoperative ideal lordosis distribution and ideal sagittal harmony on mechanical complications in patients undergoing one-level lumbar pedicle subtraction osteotomy (L-PSO). Many variables have been associated with mechanical complications after L-PSO. However, the impact of restoring the ideal inflexion point, lumbar apex, and sagittal shape is still underexplored. Analyzed risk factors were: age and patient-related variables, PSO level, interbody cages, rod material/diameter, number of rods, upper instrumented vertebra, lower instrumented vertebra, PI-LL mismatch, global tilt (GT), postoperative level of lumbar apex (LApex), postoperative level of inflexion point (InfxP), and postoperative type of Roussouly sagittal profile (R-type). These last variables were compared to ideal (based on pelvic incidence). Univariate and multivariate analyses were performed to identify risks for mechanical complications with a minimum 2-year follow-up. A total of 87 patients were included. Mean follow-up was 4.5 ± 1.7 years. 40.2% of the patients suffered postoperative mechanical complications (7 PJK, 4 PJF, 18 pseudoarthrosis/rod breakage, 6 screw pullout). Mean time for complications was 584 ± 416 days from surgery. Univariate analysis showed that age (63 vs 57 years; P = 0.04), BMI (28.1 vs 25.9; P = 0.024), preoperative-GT (50.7° vs 38.7°; P |
| Databáze: | OpenAIRE |
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