| Autor: |
Peter Gust Passias, Lara Passfall, Samantha R Horn, Katherine E Pierce, Virginie Lafage, Renaud Lafage, Justin S Smith, Breton G Line, Gregory M Mundis, Robert Eastlack, Bassel G Diebo, Themistocles S Protopsaltis, Han Jo Kim, Justin Scheer, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher P Ames, Christopher I Shaffrey, On Behalf of the International Spine Study Group |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Journal of Craniovertebral Junction and Spine, Vol 12, Iss 3, Pp 263-268 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
0974-8237 |
| DOI: |
10.4103/jcvjs.jcvjs_35_21 |
| Popis: |
Introduction: Osteotomies are commonly performed to correct sagittal malalignment in cervical deformity (CD). However, the risks and benefits of performing a major osteotomy for cervical deformity correction have been understudied. The objective of this retrospective cohort study was to investigate the risks and benefits of performing a major osteotomy for CD correction. Methods: Patients stratified based on major osteotomy (MAJ) or minor (MIN). Independent t-tests and Chi-squared tests were used to assess differences between MAJ and MIN. A sub-analysis compared patients with flexible versus rigid CL. Results: 137 CD patients were included (62 years, 65% F). 19.0% CD patients underwent a MAJ osteotomy. After propensity score matching for cSVA, 52 patients were included. About 19.0% CD patients underwent a MAJ osteotomy. MAJ patients had more minor complications (P = 0.045), despite similar surgical outcomes as MIN. At 3M, MAJ and MIN patients had similar NDI, mJOA, and EQ5D scores, however by 1 year, MAJ patients reached MCID for NDI less than MIN patients (P = 0.003). MAJ patients with rigid deformities had higher rates of complications (79% vs. 29%, P = 0.056) and were less likely to show improvement in NDI at 1 year (0.95 vs. 0.54, P = 0.027). Both groups had similar sagittal realignment at 1 year (all P > 0.05). Conclusions: Cervical deformity patients who underwent a major osteotomy had similar clinical outcomes at 3-months but worse outcomes at 1-year as compared to minor osteotomies, likely due to differences in baseline deformity. Patients with rigid deformities who underwent a major osteotomy had higher complication rates and worse clinical improvement despite similar realignment at 1 year. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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