지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.9
- 수록면
- 543 - 553 (11page)
- DOI
- 10.14245/ns.2040744.372
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초록· 키워드
오류제보하기
Objective: The demand for spinal fusion is increasing, with concurrent reports of iatrogenic adult spinal deformity (flatback deformity) possibly due to inappropriate lordosis distribution. This distribution is assessed using the lordosis distribution index (LDI) which describes the upper and lower arc lordosis ratio. Maldistributed LDI has been associated to adjacent segment disease following interbody fusion, although correlation to later-stage deformity is yet to be assessed. We therefore aimed to investigate if hypolordotic lordosis maldistribution was associated to radiographic deformity-surrogates or revision surgery following instrumented lumbar fusion.
Methods: All patients undergoing fusion surgery (≤4 vertebra) for degenerative lumbar diseases were retrospectively included at a single center. Patients were categorized according to their postoperative LDI as: “normal” (LDI 50?80), “hypolordotic” (LDI<50), or “hyperlordotic” (LDI>80).
Results: We included 149 patients who were followed for 21±14 months. Most attained a normally distributed lordosis (62%). The hypolordotic group had increased postoperative pelvic tilt (PT) (p<0.001), pelvic incidence minus lumbar lordosis (PI?LL) mismatch (p<0.001) and decreased global lordosis (p=0.007) compared to the normal group. Survival analyses revealed a significant difference in revision surgery (p=0.03), and subsequent multivariable logistic regression showed increased odds of 1-year revision in the hypolordotic group (p=0.04). There was also a negative, linear correlation between preoperative pelvic incidence (PI) and postoperative LDI (p<0.001).
Conclusion: In patients undergoing instrumented lumbar fusion surgery, hypolordotic lordosis maldistribution (LDI<50) was associated to increased risk of revision surgery, increased postoperative PT and PI?LL mismatch. Lordosis distribution should be considered prior to spinal fusion, especially in high PI patients.
목차
등록된 정보가 없습니다.
참고문헌 (45)
참고문헌 신청
Vos T / 2012 / Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 / Lancet 380:2163~2196
Fingar KR, Stocks C, Weiss AJ / Most frequent operating room procedures performed in U.S. hospitals, 2003–2012:statistical brief #186. 2014 Dec. In: Healthcare Cost and Utilization Project (HCUP) statistical briefs
Deyo RA / 2006 / Trends and variations in the use of spine surgery / Clin Orthop Relat Res 443:139~146
Weinstein JN / 2006 / United States’ trends and regional variations in lumbar spine surgery: 1992–2003 / Spine 31:2707~2714
Potter BK / 2004 / Prevention and management of iatrogenic flatback deformity / J Bone Joint Surg Am 86:1793~1808
Fingar KR, Stocks C, Weiss AJ / Most frequent operating room procedures performed in U.S. hospitals, 2003–2012:statistical brief #186. 2014 Dec. In: Healthcare Cost and Utilization Project (HCUP) statistical briefs
Deyo RA / 2006 / Trends and variations in the use of spine surgery / Clin Orthop Relat Res 443:139~146
Weinstein JN / 2006 / United States’ trends and regional variations in lumbar spine surgery: 1992–2003 / Spine 31:2707~2714
Potter BK / 2004 / Prevention and management of iatrogenic flatback deformity / J Bone Joint Surg Am 86:1793~1808
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