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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
저자정보
Kim, Yong-Chan (Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine) Kim, Ki-Tack (Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine) Kim, Cheung-Kue (Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine) Hwang, Il-Yeong (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) Jin, Woo-Young (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) Lenke, Lawrence G. (Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences) Cha, Jae-Ryong (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제5호
발행연도
2019.1
수록면
567 - 576 (10page)

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Objective : Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection. Methods : Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5-10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed. Results : Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05). Conclusion : Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.
#Spine #Joint deformities, Acquired #Osteotomy #Pseudarthrosis #Conservative management

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참고문헌 (25)

참고문헌 신청
Auerbach JD / 2012 / Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures / Spine (Phila Pa 1976) 37:1198~1210 google schola Bridwell KH / 2003 / Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance / Spine (Phila Pa 1976) 28:2093~2101 google schola Bridwell KH / 2003 / Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance / J Bone Joint Surg Am 85-A:454~463 google schola Bridwell KH / 2004 / Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Surgical technique / J Bone Joint Surg Am 86:44~50 google schola Cobb JR / 1948 / Outline for the study of scoliosis. In: instructional course lectures / J Am Acad Orthop Surg :261~275 google schola

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