Multi-Rod Constructs Can Increase the Incidence of Iliac Screw Loosening after Surgery for Adult Spinal Deformity

Tomohiro Banno; Tomohiko Hasegawa; Yu Yamato; Daisuke Togawa; Go Yoshida; Sho Kobayashi; Tatsuya Yasuda; Hideyuki Arima; Shin Oe; Yuki Mihara; Hiroki Ushirozako; Yukihiro Matsuyama

추천

검색

자료유형: 학술저널

저자정보: Tomohiro Banno (Hamamatsu University School of Medicine) Tomohiko Hasegawa (Hamamatsu University School of Medicine) Yu Yamato (Hamamatsu Medical University) Daisuke Togawa (Hamamatsu University School of Medicine) Go Yoshida (Hamamatsu Medical Center) Sho Kobayashi (Hamamatsu Medical Center Hamamatsu Japan) Tatsuya Yasuda (Hamamatsu University School of Medicine) Hideyuki Arima (Hamamatsu University School of Medicine) Shin Oe (Hamamatsu University School of Medicine) Yuki Mihara (Hamamatsu University School of Medicine) Hiroki Ushirozako (Hamamatsu University School of Medicine) Yukihiro Matsuyama (Hamamatsu University School of Medicine)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.13 No.3

발행연도: 2019.1

수록면: 500 - 510 (11page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Study Design: A retrospective study. Purpose: To investigate the incidence of iliac screw loosening with a two-rod vs. multi-rod construct and the effect on clinical and radiographic outcomes after surgery for adult spinal deformity (ASD). Overview of Literature: Multi-rod construct is useful for preventing rod fracture in ASD surgery. However, limited information is available regarding the incidence of iliac screw loosening after corrective fusion surgery using a multi-rod construct. Methods: Total 106 patients with ASD (24 men and 82 women; mean age, 68 years) who underwent corrective fusion surgery using bilateral iliac screws and were followed up for at least 1 year were reviewed. The following variables were compared between patients who underwent surgery with a two-rod and multi-rod construct: age, sex, bone mineral density (BMD), fusion level, high-grade osteotomy, L5/S interbody fusion, screw loosening (upper instrumented vertebra [UIV], S1, and iliac), rod fracture, proximal junctional kyphosis, spinopelvic parameters, and Oswestry Disability Index (ODI) score. We also compared patients with and without iliac screw loosening in the multi-rod construct group. Results: Of the 106 patients, 55 underwent surgery with a conventional two-rod construct and 51 with a multi-rod construct (three rods in 16, four rods in 35). Iliac and UIV screw loosening was observed in 24 patients (21%) and 35 patients (33%), respectively. The multi-rod group showed significantly higher incidence of iliac and UIV screw loosening and lower incidence of rod fracture. Patients with iliac screw loosening had a lower BMD than those without screw loosening; however, no significant differences were observed in the spinopelvic parameters or the ODI score. Conclusions: The use of multi-rod constructs led to a higher incidence of junctional screw loosening than the use of conventional two-rod constructs, especially in patients with osteoporosis. Iliac screw loosening did not affect sagittal alignment or clinical outcome in the short term.

#Adult spinal deformity #Complication #Iliac screw #Multi-rod construct #Screw loosening #Adult spinal deformity

참고문헌 (30)

참고문헌 신청

Schwab F / 2010 / Adult spinal deformity-postoperative standing imbalance : how much can you tolerate? : an overview of key parameters in assessing alignment and planning corrective surgery / Spine 35:2224~2231

Yamato Y / 2016 / Calculation of the target lumbar lordosis angle for restoring an optimal pelvic tilt in elderly patients with adult spinal deformity / Spine 41:E211~E217

Schwab FJ / 2012 / Risk factors for major peri-operative complications in adult spinal deformity surgery : a multi-center review of 953consecutive patients / Eur Spine J 21:2603~2610

Yamato Y / 2017 / A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity / J Orthop Sci 22:237~242

Smith JS / 2012 / Assessment of symptomatic rod fracture after posterior instrumented fusion for adult spinal deformity / Neurosurgery 71:862~867

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!