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논문 기본 정보

자료유형
학술저널
저자정보
Shimizu Takayoshi (Kyoto University Graduate School of Medicine) Fujibayashi Shunsuke (Kyoto University Graduate School of Medicine) Masuda Soichiro (Kyoto University Graduate School of Medicine) Kimura Hiroaki (Hyogo Prefectural Amagasaki General Medical Center Amagasaki Japan) Ishibe Tatsuya (Shiga Spine Center Hino Memorial Hospital Gamou Japan) Ota Masato (Orthopaedic Surgery Kitano Hospital Osaka Japan) Tamaki Yasuyuki (Red Cross Wakayama Medical Center Wakayama Japan) Onishi Eijiro (Kobe City Medical Center General Hospital Kobe Japan) Ito Hideo (Orthopaedic Surgery Kyoto Shimogamo Hospital Kyoto Japan) Otsuki Bungo (Kyoto University Graduate School of Medicine) Murata Koichi (Kyoto University Graduate School of Medicine) Matsuda Shuichi (Kyoto University Graduate School of Medicine)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.16 No.6
발행연도
2022.12
수록면
906 - 917 (12page)
DOI
10.31616/asj.2021.0421

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Study Design: A retrospective multicenter case series was conducted.Purpose: This study was designed to investigate the clinical features and surgical outcomes of lower lumbar osteoporotic vertebral collapse (LL-OVC) with symptomatic stenosis based on various surgical procedures and classify them using the newly developed collapse severity criteria.Overview of Literature: The surgical outcomes of LL-OVC with symptomatic stenosis remain unclear.Methods: We investigated patients who underwent surgical intervention for LL-OVC (L3, L4, and/or L5) with symptomatic foraminal and/or central stenosis from eight spine centers. Only patients with a minimum follow-up duration of 1 year were included. We developed new criteria to grade vertebral collapse severity (grade 1, 0%–25%; grade 2, 25%–50%; grade 3, 50%–75%; and grade 4, 75%–100%). The clinical features and outcomes were compared based on the collapse grade and surgical procedures performed (i.e., decompression alone, posterior lateral fusion [PLF], lateral interbody fusion [LIF], posterior/transforaminal interbody fusion [PLIF/TLIF], or vertebral column resection [VCR]).Results: In this study, 59 patients (average age, 77.4 years) were included. The average follow-up period was 24.6 months. The clinical outcome score (Japanese Orthopaedic Association score) was more favorable in the LIF and PLIF/TLIF groups than in the decompression alone, PLF, and VCR groups. The use of VCR was associated with a high rate of revision surgery (57.1%). No significant difference in clinical outcomes was observed between the collapse grades; however, grade 4 collapse was associated with a high rate of revision surgery (40.0%).Conclusions: When treating LL-OVC, appropriate instrumented reconstruction with rigid intervertebral stability is necessary. According to our newly developed criteria, LIF may be a surgical option for any collapse grade. The use of VCR for grade 4 collapse is associated with a high rate of revision.

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