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Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes

OBJECTIVE: Extension of the posterior upper-most instrumented vertebra (UIV) into the upper thoracic (UT) spine allows for greater deformity correction and reduced incidence of proximal junction kyphosis (PJK) in adult spinal deformity (ASD) patients. However, it may be associated with chronic posto...

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Autores principales: Haddad, Alexander F., Scheer, Justin K., Fury, Marissa T., Smith, Justin S., Deviren, Vedat, Ames, Christopher P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Spinal Neurosurgery Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497237/
https://www.ncbi.nlm.nih.gov/pubmed/34610684
http://dx.doi.org/10.14245/ns.2040576.288
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author Haddad, Alexander F.
Scheer, Justin K.
Fury, Marissa T.
Smith, Justin S.
Deviren, Vedat
Ames, Christopher P.
author_facet Haddad, Alexander F.
Scheer, Justin K.
Fury, Marissa T.
Smith, Justin S.
Deviren, Vedat
Ames, Christopher P.
author_sort Haddad, Alexander F.
collection PubMed
description OBJECTIVE: Extension of the posterior upper-most instrumented vertebra (UIV) into the upper thoracic (UT) spine allows for greater deformity correction and reduced incidence of proximal junction kyphosis (PJK) in adult spinal deformity (ASD) patients. However, it may be associated with chronic postoperative scapular pain (POSP). The goal of this study was to assess the relationship between UT UIV and persistent POSP, describe the pain, and assess its impact on patient disability. METHODS: ASD patients who underwent multilevel posterior fusion were retrospectively identified then administered a survey regarding scapular pain and the Oswestry Disability Index (ODI), by telephone. Univariate and multivariate analysis were utilized. RESULTS: A total of 74 ASD patients were included in the study: 37 patients with chronic POSP and 37 without scapular pain. The mean age was 70.5 years, and 63.9% were women. There were no significant differences in clinical characteristics, including mechanical complications (PJK, pseudarthrosis, and rod fracture) or reoperation between groups. Patients with persistent POSP were more likely to have a UT than a lower thoracic UIV (p=0.018). UT UIV was independently associated with chronic POSP on multivariate analysis (p=0.022). ODI score was significantly higher in patients with scapular pain (p=0.001). Chronic POSP (p=0.001) and prior spine surgery (p=0.037) were independently associated with ODI on multivariate analysis. CONCLUSION: A UT UIV is independently associated with increased odds of chronic POSP, and this pain is associated with significant increases in patient disability. It is a significant clinical problem despite solid radiographic fusion and the absence of PJK.
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spelling pubmed-84972372021-10-15 Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes Haddad, Alexander F. Scheer, Justin K. Fury, Marissa T. Smith, Justin S. Deviren, Vedat Ames, Christopher P. Neurospine Original Article OBJECTIVE: Extension of the posterior upper-most instrumented vertebra (UIV) into the upper thoracic (UT) spine allows for greater deformity correction and reduced incidence of proximal junction kyphosis (PJK) in adult spinal deformity (ASD) patients. However, it may be associated with chronic postoperative scapular pain (POSP). The goal of this study was to assess the relationship between UT UIV and persistent POSP, describe the pain, and assess its impact on patient disability. METHODS: ASD patients who underwent multilevel posterior fusion were retrospectively identified then administered a survey regarding scapular pain and the Oswestry Disability Index (ODI), by telephone. Univariate and multivariate analysis were utilized. RESULTS: A total of 74 ASD patients were included in the study: 37 patients with chronic POSP and 37 without scapular pain. The mean age was 70.5 years, and 63.9% were women. There were no significant differences in clinical characteristics, including mechanical complications (PJK, pseudarthrosis, and rod fracture) or reoperation between groups. Patients with persistent POSP were more likely to have a UT than a lower thoracic UIV (p=0.018). UT UIV was independently associated with chronic POSP on multivariate analysis (p=0.022). ODI score was significantly higher in patients with scapular pain (p=0.001). Chronic POSP (p=0.001) and prior spine surgery (p=0.037) were independently associated with ODI on multivariate analysis. CONCLUSION: A UT UIV is independently associated with increased odds of chronic POSP, and this pain is associated with significant increases in patient disability. It is a significant clinical problem despite solid radiographic fusion and the absence of PJK. Korean Spinal Neurosurgery Society 2021-09 2021-09-30 /pmc/articles/PMC8497237/ /pubmed/34610684 http://dx.doi.org/10.14245/ns.2040576.288 Text en Copyright © 2021 by the Korean Spinal Neurosurgery Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Haddad, Alexander F.
Scheer, Justin K.
Fury, Marissa T.
Smith, Justin S.
Deviren, Vedat
Ames, Christopher P.
Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title_full Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title_fullStr Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title_full_unstemmed Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title_short Incidence of Chronic Periscapular Pain After Adult Thoracolumbar Deformity Correction and Impact on Outcomes
title_sort incidence of chronic periscapular pain after adult thoracolumbar deformity correction and impact on outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497237/
https://www.ncbi.nlm.nih.gov/pubmed/34610684
http://dx.doi.org/10.14245/ns.2040576.288
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