AI Article Synopsis
- The study was a retrospective analysis focusing on how bone mineral density (BMD) affects surgical outcomes for patients with lumbar degenerative kyphosis (LDK).
- No prior research has examined the link between BMD and surgical correction of LDK, highlighting a gap in existing literature.
- Although osteoporosis was common among the patients, it did not significantly impact surgical correction or long-term complications, while the difference in lumbar lordosis versus pelvic incidence was associated with complications.
Article Abstract
Study Design: Retrospective study.
Purpose: To investigate influence of bone mineral density (BMD) on the surgical correction of lumbar degenerative kyphosis (LDK).
Overview Of Literature: No studies so far have reported the influence of BMD on the surgical correction of LDK.
Methods: Forty LDK patients with more than 2 years follow-up were studied. Pelvic incidence (PI), pelvic tilt, sacral slope, sagittal vertical axis (SVA), lumbar lordosis (LL), and thoracic kyphosis were measured preoperatively, immediate postoperatively and at final follow-up. Adverse outcomes: proximal adjacent fractures, sagittal decompensation, pseudoarthrosis, and cage subsidence were documented.
Results: There were 37 females and 3 males. Average age was 65.1±4.5 years and mean follow-up was 34.2±16.7 months. 42.5% were Takemitsu type 3 curves, 27.5% type 2, 20.0% type 4 and 10.0% type 1. 37.5% had osteopenia, 40.0% osteoporosis and 22.5% had severe osteoporosis. SVA improved from 237.0±96.7 mm preoperatively to 45.3±41.8 mm postoperatively (p=0.000). LL improved from 10.5°±14.7° to -40.6°±10.9° postoperatively (p=0.000). At final follow-up SVA deteriorated to 89.8±72.2 mm and LL to 34.7°±15.8° (p=0.000). The association between late sagittal decompensation, pseudoarthrosis, or proximal adjacent fractures and osteoporosis was insignificant. The difference between immediate postoperative LL and PI (PIDiff) had a significant association with sagittal decompensation and pseudoarthrosis.
Conclusions: Osteoporosis did not influence the degree of correction, late sagittal decompensation, proximal adjacent fractures, and pseudoarthrosis in LDK. PIDiff had a significant association with sagittal decompensation and pseudoarthrosis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330221 | PMC |
| http://dx.doi.org/10.4184/asj.2015.9.1.65 | DOI Listing |
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