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The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening

OBJECTIVE: To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. METHODS: We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the...

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Autores principales: Kim, Jin-Bum, Park, Seung-Won, Lee, Young-Seok, Nam, Taek-Kyun, Park, Yong-Sook, Kim, Young-Baeg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Neurosurgical Society 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651997/
https://www.ncbi.nlm.nih.gov/pubmed/26587190
http://dx.doi.org/10.3340/jkns.2015.58.4.357
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author Kim, Jin-Bum
Park, Seung-Won
Lee, Young-Seok
Nam, Taek-Kyun
Park, Yong-Sook
Kim, Young-Baeg
author_facet Kim, Jin-Bum
Park, Seung-Won
Lee, Young-Seok
Nam, Taek-Kyun
Park, Yong-Sook
Kim, Young-Baeg
author_sort Kim, Jin-Bum
collection PubMed
description OBJECTIVE: To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. METHODS: We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. RESULTS: Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was 7.3±4.1 months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). CONCLUSION: In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening.
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spelling pubmed-46519972015-11-19 The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening Kim, Jin-Bum Park, Seung-Won Lee, Young-Seok Nam, Taek-Kyun Park, Yong-Sook Kim, Young-Baeg J Korean Neurosurg Soc Clinical Article OBJECTIVE: To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. METHODS: We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. RESULTS: Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was 7.3±4.1 months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). CONCLUSION: In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening. The Korean Neurosurgical Society 2015-10 2015-10-30 /pmc/articles/PMC4651997/ /pubmed/26587190 http://dx.doi.org/10.3340/jkns.2015.58.4.357 Text en Copyright © 2015 The Korean Neurosurgical Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Kim, Jin-Bum
Park, Seung-Won
Lee, Young-Seok
Nam, Taek-Kyun
Park, Yong-Sook
Kim, Young-Baeg
The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title_full The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title_fullStr The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title_full_unstemmed The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title_short The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening
title_sort effects of spinopelvic parameters and paraspinal muscle degeneration on s1 screw loosening
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651997/
https://www.ncbi.nlm.nih.gov/pubmed/26587190
http://dx.doi.org/10.3340/jkns.2015.58.4.357
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