Identification of Predictive Factors for Mechanical Complications After Adult Spinal Deformity Surgery: A Multi-Institutional Retrospective Study.
Aged
Aged, 80 and over
Biomechanical Phenomena
/ physiology
Female
Humans
Kyphosis
/ diagnostic imaging
Lumbar Vertebrae
/ diagnostic imaging
Male
Middle Aged
Neurosurgical Procedures
/ adverse effects
Postoperative Complications
/ diagnostic imaging
Predictive Value of Tests
Retrospective Studies
Spinal Diseases
/ diagnostic imaging
Thoracic Vertebrae
/ diagnostic imaging
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Sep 2020
01 Sep 2020
Historique:
pubmed:
25
3
2020
medline:
17
12
2020
entrez:
25
3
2020
Statut:
ppublish
Résumé
A retrospective multicenter observational study. To investigate correction surgeries that were performed in relatively aged patients in terms of mechanical complications (MCs) and their predictive factors. The risk factors associated with MCs have not yet been well examined, especially in aged populations. We retrospectively reviewed 230 surgically treated ASD patients with an average age of 72.2 years. Twenty-eight patients with ASD caused by vertebral fractures were excluded. The minimum follow-up was 2 years. Postoperative MCs were defined as proximal junction kyphosis, distal junction kyphosis, pseudoarthrosis, rod breakage, and vertebral fractures. We divided all the ASD patients into two groups: patients with MC (the MC (+) group) and patients without MC (the MC (-) group). Radiographic parameters were evaluated before and immediately after surgery. The SRS-Schwab ASD classification and global alignment and proportion (GAP) score were also evaluated. Of the 202 patients, 91 (45.0%) had MCs. The age at surgery was significantly higher in the MC (+) group than in the MC (-) group. Regarding radiographic parameters, postoperative global tilt (GT), pre- and postoperative thoracolumbar kyphosis (TLK), and postoperative thoracic kyphosis were significantly higher in the MC (+) group than in the MC (-) group. Other parameters, such as the proposed ideal alignment target of PI-LL<10, did not significantly affect MC rates. The GAP score was high in both groups and not significantly related to a higher rate of MC. Forward stepwise logistic regression indicated that the age at surgery, postoperative GT, and preoperative TLK were significant risk factors for MCs. Older age, higher postoperative GT, and higher pre and postoperative TLK can be risk factors for MCs. The GAP score was high in both groups and not significantly related to a higher rate of MC. 4.
Sections du résumé
STUDY DESIGN
METHODS
A retrospective multicenter observational study.
OBJECTIVE
OBJECTIVE
To investigate correction surgeries that were performed in relatively aged patients in terms of mechanical complications (MCs) and their predictive factors.
SUMMARY OF BACKGROUND DATA
BACKGROUND
The risk factors associated with MCs have not yet been well examined, especially in aged populations.
METHODS
METHODS
We retrospectively reviewed 230 surgically treated ASD patients with an average age of 72.2 years. Twenty-eight patients with ASD caused by vertebral fractures were excluded. The minimum follow-up was 2 years. Postoperative MCs were defined as proximal junction kyphosis, distal junction kyphosis, pseudoarthrosis, rod breakage, and vertebral fractures. We divided all the ASD patients into two groups: patients with MC (the MC (+) group) and patients without MC (the MC (-) group). Radiographic parameters were evaluated before and immediately after surgery. The SRS-Schwab ASD classification and global alignment and proportion (GAP) score were also evaluated.
RESULTS
RESULTS
Of the 202 patients, 91 (45.0%) had MCs. The age at surgery was significantly higher in the MC (+) group than in the MC (-) group. Regarding radiographic parameters, postoperative global tilt (GT), pre- and postoperative thoracolumbar kyphosis (TLK), and postoperative thoracic kyphosis were significantly higher in the MC (+) group than in the MC (-) group. Other parameters, such as the proposed ideal alignment target of PI-LL<10, did not significantly affect MC rates. The GAP score was high in both groups and not significantly related to a higher rate of MC. Forward stepwise logistic regression indicated that the age at surgery, postoperative GT, and preoperative TLK were significant risk factors for MCs.
CONCLUSION
CONCLUSIONS
Older age, higher postoperative GT, and higher pre and postoperative TLK can be risk factors for MCs. The GAP score was high in both groups and not significantly related to a higher rate of MC.
LEVEL OF EVIDENCE
METHODS
4.
Identifiants
pubmed: 32205686
doi: 10.1097/BRS.0000000000003500
pii: 00007632-202009010-00007
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1185-1192Références
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