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Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis

STUDY DESIGN: Retrospective case–control study. OBJECTIVES: Proximal junctional kyphosis (PJK) is a postoperative complication involving the proximal segments which is commonly seen in patients with degenerative spine diseases (DSD). The purpose of the present study was to identify predictive factor...

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Autores principales: Zhang, Tong-tong, Ding, Jun-zhe, Kong, Chao, Zhu, Wei-guo, Wang, Shuai-kang, Lu, Shi-bao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694918/
https://www.ncbi.nlm.nih.gov/pubmed/36424631
http://dx.doi.org/10.1186/s12891-022-05960-z
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author Zhang, Tong-tong
Ding, Jun-zhe
Kong, Chao
Zhu, Wei-guo
Wang, Shuai-kang
Lu, Shi-bao
author_facet Zhang, Tong-tong
Ding, Jun-zhe
Kong, Chao
Zhu, Wei-guo
Wang, Shuai-kang
Lu, Shi-bao
author_sort Zhang, Tong-tong
collection PubMed
description STUDY DESIGN: Retrospective case–control study. OBJECTIVES: Proximal junctional kyphosis (PJK) is a postoperative complication involving the proximal segments which is commonly seen in patients with degenerative spine diseases (DSD). The purpose of the present study was to identify predictive factors for postoperative PJK in elderly patients with DSD. METHODS: We reviewed elderly patients with DSD who underwent thoracolumbar fusion involving no less than 3 levels. Patients who developed PJK were propensity score-matched with patients with DSD who received the same procedure but did not develop PJK. Demographic characteristics, sagittal vertical axis (SVA), computed tomography (CT) value (Hounsfield unit), and paraspinal muscle parameters were compared between PJK and non-PJK groups. RESULTS: Eighty-three PJK and non-PJK patients were selected by propensity score matching for age, sex, history of smoking, body mass index, number of fused segments, and upper instrumented vertebra (UIV) location. SVA showed no significant difference between the two groups. In PJK group, fatty infiltration (FI) in erector spinae and multifidus was significantly greater, while the relative cross-sectional area (rCSA) of erector spinae was significantly smaller than that in non-PJK group. CT value was significantly lower in PJK group. Lower erector spinae rCSA and CT value of the UIV, higher erector spinae FI and multifidus FI were identified as predictors of postoperative PJK. CONCLUSIONS: PJK is a common complication in older patients with DSD. Paraspinal muscle degeneration and low bone mineral density of the UIV are predictors of PJK. Protective measures targeting paraspinal muscles and the UIV may help prevent postoperative PJK. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-022-05960-z.
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spelling pubmed-96949182022-11-26 Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis Zhang, Tong-tong Ding, Jun-zhe Kong, Chao Zhu, Wei-guo Wang, Shuai-kang Lu, Shi-bao BMC Musculoskelet Disord Research STUDY DESIGN: Retrospective case–control study. OBJECTIVES: Proximal junctional kyphosis (PJK) is a postoperative complication involving the proximal segments which is commonly seen in patients with degenerative spine diseases (DSD). The purpose of the present study was to identify predictive factors for postoperative PJK in elderly patients with DSD. METHODS: We reviewed elderly patients with DSD who underwent thoracolumbar fusion involving no less than 3 levels. Patients who developed PJK were propensity score-matched with patients with DSD who received the same procedure but did not develop PJK. Demographic characteristics, sagittal vertical axis (SVA), computed tomography (CT) value (Hounsfield unit), and paraspinal muscle parameters were compared between PJK and non-PJK groups. RESULTS: Eighty-three PJK and non-PJK patients were selected by propensity score matching for age, sex, history of smoking, body mass index, number of fused segments, and upper instrumented vertebra (UIV) location. SVA showed no significant difference between the two groups. In PJK group, fatty infiltration (FI) in erector spinae and multifidus was significantly greater, while the relative cross-sectional area (rCSA) of erector spinae was significantly smaller than that in non-PJK group. CT value was significantly lower in PJK group. Lower erector spinae rCSA and CT value of the UIV, higher erector spinae FI and multifidus FI were identified as predictors of postoperative PJK. CONCLUSIONS: PJK is a common complication in older patients with DSD. Paraspinal muscle degeneration and low bone mineral density of the UIV are predictors of PJK. Protective measures targeting paraspinal muscles and the UIV may help prevent postoperative PJK. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-022-05960-z. BioMed Central 2022-11-23 /pmc/articles/PMC9694918/ /pubmed/36424631 http://dx.doi.org/10.1186/s12891-022-05960-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhang, Tong-tong
Ding, Jun-zhe
Kong, Chao
Zhu, Wei-guo
Wang, Shuai-kang
Lu, Shi-bao
Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title_full Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title_fullStr Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title_full_unstemmed Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title_short Paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
title_sort paraspinal muscle degeneration and lower bone mineral density as predictors of proximal junctional kyphosis in elderly patients with degenerative spinal diseases: a propensity score matched case–control analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694918/
https://www.ncbi.nlm.nih.gov/pubmed/36424631
http://dx.doi.org/10.1186/s12891-022-05960-z
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