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Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study

Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to...

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Autores principales: Asada, Tomoyuki, Miura, Kousei, Koda, Masao, Kadone, Hideki, Funayama, Toru, Takahashi, Hiroshi, Noguchi, Hiroshi, Shibao, Yosuke, Sato, Kosuke, Eto, Fumihiko, Mataki, Kentaro, Yamazaki, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572172/
https://www.ncbi.nlm.nih.gov/pubmed/36233737
http://dx.doi.org/10.3390/jcm11195871
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author Asada, Tomoyuki
Miura, Kousei
Koda, Masao
Kadone, Hideki
Funayama, Toru
Takahashi, Hiroshi
Noguchi, Hiroshi
Shibao, Yosuke
Sato, Kosuke
Eto, Fumihiko
Mataki, Kentaro
Yamazaki, Masashi
author_facet Asada, Tomoyuki
Miura, Kousei
Koda, Masao
Kadone, Hideki
Funayama, Toru
Takahashi, Hiroshi
Noguchi, Hiroshi
Shibao, Yosuke
Sato, Kosuke
Eto, Fumihiko
Mataki, Kentaro
Yamazaki, Masashi
author_sort Asada, Tomoyuki
collection PubMed
description Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK. Methods: We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (−). Results: PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (−) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, p = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK. Conclusions: Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD.
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spelling pubmed-95721722022-10-17 Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study Asada, Tomoyuki Miura, Kousei Koda, Masao Kadone, Hideki Funayama, Toru Takahashi, Hiroshi Noguchi, Hiroshi Shibao, Yosuke Sato, Kosuke Eto, Fumihiko Mataki, Kentaro Yamazaki, Masashi J Clin Med Article Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK. Methods: We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (−). Results: PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (−) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, p = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK. Conclusions: Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD. MDPI 2022-10-04 /pmc/articles/PMC9572172/ /pubmed/36233737 http://dx.doi.org/10.3390/jcm11195871 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Asada, Tomoyuki
Miura, Kousei
Koda, Masao
Kadone, Hideki
Funayama, Toru
Takahashi, Hiroshi
Noguchi, Hiroshi
Shibao, Yosuke
Sato, Kosuke
Eto, Fumihiko
Mataki, Kentaro
Yamazaki, Masashi
Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title_full Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title_fullStr Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title_full_unstemmed Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title_short Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
title_sort can proximal junctional kyphosis after surgery for adult spinal deformity be predicted by preoperative dynamic sagittal alignment change with 3d gait analysis? a case–control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572172/
https://www.ncbi.nlm.nih.gov/pubmed/36233737
http://dx.doi.org/10.3390/jcm11195871
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