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Sagittal alignment of diverse mechanical complications following adult spinal deformity surgery.
- Source :
-
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 May; Vol. 33 (5), pp. 1857-1867. Date of Electronic Publication: 2024 Jan 25. - Publication Year :
- 2024
-
Abstract
- Purpose: To compare the sagittal alignment of patients with diverse mechanical complications (MCs) following adult spinal deformity (ASD) surgery with that of patients without MCs.<br />Methods: A total of 371 patients who underwent ASD surgery were enrolled. The sagittal spinopelvic parameters were measured preoperatively and at the 6-month and last follow-up, and the global alignment and proportion (GAP) score was calculated. The subjects were divided into non-MC and MCs groups, and the MCs group was further divided into rod fracture (RF), screw breakage (SB), screw dislodgement (SD) and proximal junctional kyphosis (PJK) subgroups.<br />Results: Preoperatively, the RF group had greater thoracolumbar kyphosis (TLK) and relative upper lumbar lordosis (RULL); the SB group had the largest pelvic incidence (PI) and lumbar lordosis (LL); the SD group had the least global sagittal imbalance; and the PJK group had the highest thoracic kyphosis (TK), TLK and RULL. At the last follow-up, the RF and SB groups featured a large PI minus LL (PI-LL), while the PJK group featured a prominent TK; all the MCs subgroups had sagittal malalignment and a higher GAP score, and the SB group had the most severe cases. Logistic regressions showed that the relative spinopelvic alignment (RSA) score was correlated with RF, SB and SD, while the RSA and age scores were associated with PJK.<br />Conclusion: Each patient with MCs had individual characteristics in the sagittal plane following ASD surgery, which may be helpful to understand the pathophysiology of poor sagittal alignment with its subsequent MCs and guide an eventual revision strategy.<br /> (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Subjects :
- Humans
Female
Male
Middle Aged
Aged
Adult
Lordosis surgery
Lordosis diagnostic imaging
Lordosis etiology
Spinal Fusion adverse effects
Spinal Fusion instrumentation
Spinal Fusion methods
Spinal Curvatures surgery
Spinal Curvatures diagnostic imaging
Retrospective Studies
Lumbar Vertebrae surgery
Lumbar Vertebrae diagnostic imaging
Thoracic Vertebrae surgery
Thoracic Vertebrae diagnostic imaging
Postoperative Complications etiology
Postoperative Complications epidemiology
Kyphosis surgery
Kyphosis etiology
Kyphosis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0932
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
- Publication Type :
- Academic Journal
- Accession number :
- 38270602
- Full Text :
- https://doi.org/10.1007/s00586-023-08126-0