Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities
Objective. To analyze the significance of the influence of various risk factors on the development of proximal junctional kyphosis (PJK) and instability of instrumentation. Material and Methods. The results of surgical treatment of 382 patients with scoliotic deformities of the lumbar spine of ty...
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Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2021-03-01
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doaj-1473aaebe77b4b5abd0f1c0aca2aad122021-08-31T06:33:40ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972021-03-01181142310.14531/ss2021.1.14-23Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformitiesIgor V. Basankin0https://orcid.org/0000-0003-3549-0794Dmitry A. Ptashnikov1https://orcid.org/0000-0001-5765-3158Sergey V. Masevnin2https://orcid.org/0000-0002-9853-7089Asker A. Afaunov3https://orcid.org/0000-0001-7976-860XAbram A. Giulzatyan4https://orcid.org/0000-0003-1260-4007Karapet K. Takhmazyan5https://orcid.org/0000-0002-4496-2709Research Institute – Krasnodar Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, RussiaRussian Scientific Research Institute of Traumatology and Orthopedics n.a. R.R. Vreden, St. Petersburg, RussiaRussian Scientific Research Institute of Traumatology and Orthopedics n.a. R.R. Vreden, St. Petersburg, RussiaKuban State Medical University, Krasnodar, RussiaResearch Institute – Krasnodar Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, RussiaResearch Institute – Krasnodar Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, RussiaObjective. To analyze the significance of the influence of various risk factors on the development of proximal junctional kyphosis (PJK) and instability of instrumentation. Material and Methods. The results of surgical treatment of 382 patients with scoliotic deformities of the lumbar spine of type I and IIIb according to Aebi were analyzed. Patients were operated on through the posterior approach using the TLIF-PLIF technique with extended rigid transpedicular instrumentation. Potential risk factors influencing the development of proximal junctional kyphosis and instability of instrumentation were analyzed. Results. It was found that only three risk factors significantly affect the development of PJK: correction of lumbar lordosis more than 30° (p = 0.036) increases the likelihood of its development by 1.5 times, osteoporosis (p = 0.001) – by 2.5 times, and proximal junctional angle ≥10° (p = 0.001) – by 3.5 times. Three factors showed a statistically significant effect on the incidence of instrumentation instability: correction of lumbar lordosis more than 30° (p = 0.034) increases the likelihood of its occurrence by 1.7 times, osteoporosis (p = 0.018) – by 1.8 times, and deviation of the sagittal vertical axis by more than 50 mm (p = 0.001) – by 3.3 times. Conclusion. The most significant risk factors for the occurrence of PJK and instability of instrumentation are osteoporosis, correction of lumbar lordosis more than 30°, an increase in the proximal junctional angle ≥10°, and an anterior deviation of sagittal vertical axis more than 50 mm. Consideration of these factors in the preoperative period, as well as during surgery, can decrease likelihood of the occurrence of PJK and instability of instrumentation.https://www.spinesurgery.ru/jour/article/view/1774/1769degenerative scoliosisproximal junctional kyphosisinstability of instrumentationrisk factorsosteoporosisdeformity correction |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Igor V. Basankin Dmitry A. Ptashnikov Sergey V. Masevnin Asker A. Afaunov Abram A. Giulzatyan Karapet K. Takhmazyan |
spellingShingle |
Igor V. Basankin Dmitry A. Ptashnikov Sergey V. Masevnin Asker A. Afaunov Abram A. Giulzatyan Karapet K. Takhmazyan Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities Хирургия позвоночника degenerative scoliosis proximal junctional kyphosis instability of instrumentation risk factors osteoporosis deformity correction |
author_facet |
Igor V. Basankin Dmitry A. Ptashnikov Sergey V. Masevnin Asker A. Afaunov Abram A. Giulzatyan Karapet K. Takhmazyan |
author_sort |
Igor V. Basankin |
title |
Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
title_short |
Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
title_full |
Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
title_fullStr |
Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
title_full_unstemmed |
Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
title_sort |
significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities |
publisher |
Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
series |
Хирургия позвоночника |
issn |
1810-8997 2313-1497 |
publishDate |
2021-03-01 |
description |
Objective. To analyze the significance of the influence of various risk factors on the development of proximal junctional kyphosis (PJK) and instability of instrumentation.
Material and Methods. The results of surgical treatment of 382 patients with scoliotic deformities of the lumbar spine of type I and IIIb according to Aebi were analyzed. Patients were operated on through the posterior approach using the TLIF-PLIF technique with extended rigid transpedicular instrumentation. Potential risk factors influencing the development of proximal junctional kyphosis and instability of instrumentation were analyzed.
Results. It was found that only three risk factors significantly affect the development of PJK: correction of lumbar lordosis more than 30° (p = 0.036) increases the likelihood of its development by 1.5 times, osteoporosis (p = 0.001) – by 2.5 times, and proximal junctional
angle ≥10° (p = 0.001) – by 3.5 times. Three factors showed a statistically significant effect on the incidence of instrumentation instability: correction of lumbar lordosis more than 30° (p = 0.034) increases the likelihood of its occurrence by 1.7 times, osteoporosis (p = 0.018) – by 1.8 times, and deviation of the sagittal vertical axis by more than 50 mm (p = 0.001) – by 3.3 times.
Conclusion. The most significant risk factors for the occurrence of PJK and instability of instrumentation are osteoporosis, correction of lumbar lordosis more than 30°, an increase in the proximal junctional angle ≥10°, and an anterior deviation of sagittal vertical axis more than 50 mm. Consideration of these factors in the preoperative period, as well as during surgery, can decrease likelihood of the occurrence of PJK and instability of instrumentation. |
topic |
degenerative scoliosis proximal junctional kyphosis instability of instrumentation risk factors osteoporosis deformity correction |
url |
https://www.spinesurgery.ru/jour/article/view/1774/1769 |
work_keys_str_mv |
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