Cargando…

Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level

Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was...

Descripción completa

Detalles Bibliográficos
Autores principales: Lundine, Kristopher, Turner, Peter, Johnson, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864414/
https://www.ncbi.nlm.nih.gov/pubmed/24353949
http://dx.doi.org/10.1055/s-0032-1319771
_version_ 1782295927083499520
author Lundine, Kristopher
Turner, Peter
Johnson, Michael
author_facet Lundine, Kristopher
Turner, Peter
Johnson, Michael
author_sort Lundine, Kristopher
collection PubMed
description Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was the development of distal junctional kyphosis (DJK). Summary of Background Data Prior research has pointed to selection of the FLV for the distal instrumentation level in fusion for thoracic hyperkyphosis. In 2009, Cho et al introduced the concept of the SSV after recognizing the development of DJK despite fusion to the FLV. Methods Patients were reviewed who had undergone spinal fusion for thoracic hyperkyphosis. Preoperative radiographs were reviewed to assess thoracic kyphosis, lumbar lordosis, SSV, and FLV. Postoperative radiographs were reviewed to assess curve correction and whether patients developed DJK or implant failure. Results We reviewed 22 patients with a mean age at surgery of 18 (range 14 to 22). Mean preoperative kyphosis was 85 ± 14 degrees, and mean postoperative kyphosis at final follow-up was 59 ± 12 degrees for a mean correction of 26 ± 12 degrees. Eleven patients developed DJK and four patients experienced hardware failure. In 12 patients, the SSV was inferior to the FLV. Rates of DJK when the instrumentation included the SSV or FLV were 13 and 38%, respectively. Conclusions Fusion to the SSV is superior at preventing DJK when compared with fusion to the FLV.
format Online
Article
Text
id pubmed-3864414
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Thieme Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-38644142013-12-18 Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level Lundine, Kristopher Turner, Peter Johnson, Michael Global Spine J Article Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was the development of distal junctional kyphosis (DJK). Summary of Background Data Prior research has pointed to selection of the FLV for the distal instrumentation level in fusion for thoracic hyperkyphosis. In 2009, Cho et al introduced the concept of the SSV after recognizing the development of DJK despite fusion to the FLV. Methods Patients were reviewed who had undergone spinal fusion for thoracic hyperkyphosis. Preoperative radiographs were reviewed to assess thoracic kyphosis, lumbar lordosis, SSV, and FLV. Postoperative radiographs were reviewed to assess curve correction and whether patients developed DJK or implant failure. Results We reviewed 22 patients with a mean age at surgery of 18 (range 14 to 22). Mean preoperative kyphosis was 85 ± 14 degrees, and mean postoperative kyphosis at final follow-up was 59 ± 12 degrees for a mean correction of 26 ± 12 degrees. Eleven patients developed DJK and four patients experienced hardware failure. In 12 patients, the SSV was inferior to the FLV. Rates of DJK when the instrumentation included the SSV or FLV were 13 and 38%, respectively. Conclusions Fusion to the SSV is superior at preventing DJK when compared with fusion to the FLV. Thieme Medical Publishers 2012-06 /pmc/articles/PMC3864414/ /pubmed/24353949 http://dx.doi.org/10.1055/s-0032-1319771 Text en © Thieme Medical Publishers
spellingShingle Article
Lundine, Kristopher
Turner, Peter
Johnson, Michael
Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title_full Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title_fullStr Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title_full_unstemmed Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title_short Thoracic Hyperkyphosis: Assessment of the Distal Fusion Level
title_sort thoracic hyperkyphosis: assessment of the distal fusion level
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864414/
https://www.ncbi.nlm.nih.gov/pubmed/24353949
http://dx.doi.org/10.1055/s-0032-1319771
work_keys_str_mv AT lundinekristopher thoracichyperkyphosisassessmentofthedistalfusionlevel
AT turnerpeter thoracichyperkyphosisassessmentofthedistalfusionlevel
AT johnsonmichael thoracichyperkyphosisassessmentofthedistalfusionlevel