Aim: To analyze the risk factors of proximal junctional kyphosis (PJK) after correction surgery in patients with adolescent idiopathic scoliosis (AIS).
Methods: PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, and EMCC databases were searched for retrospective studies utilizing all AIS patients with PJK after corrective surgery to collect preoperative, postoperative, and follow-up imaging parameters, including thoracic kyphosis (TK), lumbar lordosis (LL), proximal junctional angle (PJA), the sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), pelvic incidence-lumbar lordosis (PI-LL), sacral slope (SS), rod contour angle (RCA) and upper instrumented vertebra (UIV).
Results: Nineteen retrospective studies were included in this meta-analysis, including 550 patients in the intervention group and 3456 patients in the control group. Overall, sex (OR 1.40, 95% CI (1.08, 1.83), P = 0.01), larger preoperative TK (WMD 6.82, 95% CI (5.48, 8.16), P < 0.00001), larger follow-up TK (WMD 8.96, 95% CI (5.62, 12.30), P < 0.00001), larger postoperative LL (WMD 2.31, 95% CI (0.91, 3.71), P = 0.001), larger follow-up LL (WMD 2.51, 95% CI (1.19, 3.84), P = 0.0002), great change in LL (WMD - 2.72, 95% CI (- 4.69, - 0.76), P = 0.006), larger postoperative PJA (WMD 4.94, 95% CI (3.62, 6.26), P < 0.00001), larger follow-up PJA (WMD 13.39, 95% CI (11.09, 15.69), P < 0.00001), larger postoperative PI-LL (WMD - 9.57, 95% CI (- 17.42, - 1.71), P = 0.02), larger follow-up PI-LL (WMD - 12.62, 95% CI (- 17.62, - 7.62), P < 0.00001), larger preoperative SVA (WMD 0.73, 95% CI (0.26, 1.19), P = 0.002), larger preoperative SS (WMD - 3.43, 95% CI (- 4.71, - 2.14), P < 0.00001), RCA (WMD 1.66, 95% CI (0.48, 2.84), P = 0.006) were identified as risk factors for PJK in patients with AIS. For patients with Lenke 5 AIS, larger preoperative TK (WMD 7.85, 95% CI (5.69, 10.00), P < 0.00001), larger postoperative TK (WMD 9.66, 95% CI (1.06, 18.26), P = 0.03, larger follow-up TK (WMD 11.92, 95% CI (6.99, 16.86), P < 0.00001, larger preoperative PJA (WMD 0.72, 95% CI (0.03, 1.41), P = 0.04, larger postoperative PJA (WMD 5.54, 95% CI (3.57, 7.52), P < 0.00001), larger follow-up PJA (WMD 12.42, 95% CI 9.24, 15.60), P < 0.00001, larger follow-up SVA (WMD 0.07, 95% CI (- 0.46, 0.60), P = 0.04), larger preoperative PT (WMD - 3.04, 95% CI (- 5.27, - 0.81), P = 0.008, larger follow-up PT (WMD - 3.69, 95% CI (- 6.66, - 0.72), P = 0.02) were identified as risk factors for PJK.
Conclusion: Following corrective surgery, 19% of AIS patients experienced PJK, with Lenke 5 contributing to 25%. Prior and post-op measurements play significant roles in predicting PJK occurrence; thus, meticulous, personalized preoperative planning is crucial. This includes considering individualized treatments based on the Lenke classification as our future evaluation standard.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988869 | PMC |
| http://dx.doi.org/10.1186/s13018-024-04638-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intravenous Efgartigimod Alfa as Initial Monotherapy for Disabling Ocular Myasthenia in an Elderly Patient with Multiple Comorbidities.
Cureus
November 2024
Neurology, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.
Myasthenia gravis (MG) is one of the most common neuromuscular disorders. It is an antibody-mediated autoimmune disease affecting the neuromuscular junction, presenting with fluctuating muscle weakness that commonly affects the ocular, bulbar, proximal, and respiratory muscles. Treating MG in the older population with preexisting comorbidities can be challenging.
View Article and Find Full Text PDFFlush endovenous laser ablation (fEVLA) in the treatment of lower limb venous insufficiency a systematic review and meta-analysis.
Ann Vasc Surg
December 2024
Department of Vascular Surgery, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.
Purpose: To assess the safety and efficacy of flush endovenous laser ablation (fEVLA) in the treatment of chronic venous insufficiency.
Materials And Methods: Following the PRISMA 2020 guidelines, a systematic review aiming to identify studies published from inception to March 2024 was conducted. The investigation covered single-arm studies and studies comparing fEVLA to standard EVLA (sEVLA).
Do Emergency Department Observation Units Help Prevent Revisits for Patients with Renal Colic?
Am J Emerg Med
December 2024
Department of Emergency Medicine, Good Samaritan University Hospital, 1000 Montauk Highway, West Islip, New York, United States of America. Electronic address:
Introduction: Renal colic is generally considered a diagnosis appropriate for discharge home once pain is adequately controlled and no other admission criteria are met. The increasing prevalence of ED observation units (EDOU) represent another disposition option for patients with renal colic. In this study, we sought to describe the rates of 14-day revisits for renal colic among patients placed in an EDOU as compared to those discharged from the ED.
View Article and Find Full Text PDFDevelopment and validation of a preoperative model for predicting positive proximal margins in adenocarcinoma of the esophagogastric junction and assessing safe margin distance.
Front Oncol
December 2024
Department of Gastrointestinal, Hengshui People's Hospital, Hengshui, Hebei, China.
Objective: To develop and validate a model for preoperative prediction of positive proximal margins for adenocarcinoma of the esophagogastric junction (AEG) by transabdominal approach, and to analyze the safe margin distances for patients with different risks of positive proximal margins.
Materials And Methods: A retrospective analysis was performed on 284 AEG patients who underwent surgery via the transabdominal approach at Hengshui People's Hospital between January 2017 and December 2023. Patients were divided into a training set (=201, first five years) and a test set (=83, last two years).
Adolescent vs. Young Adult Idiopathic Scoliosis patients: how different are their two year postoperative radiographic and clinical outcomes?
Eur Spine J
December 2024
Department of Orthopaedic Surgery, Columbia University Irving Medical Center, The Och Spine Hospital at NewYork Presbyterian, New York, NY, 10032, USA.
Purpose: To compare the long-term outcomes among AIS (10-18 years) and young AdIS (YAdIS) (19-40 years) patients with minimum 2 year follow up.
Methods: A retrospective review of AIS and YAdIS patients who underwent primary corrective surgery at a single center was conducted. Demographic, radiographic, operative data, patient reported outcome measures (PROMs), including the ODI and SRS-22r, and long-term complications were collected.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!