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논문 기본 정보

자료유형
학술저널
저자정보
Scott L. Zuckerman (Columbia University Medical Center) Christopher S. Lai (Columbia University Medical Center) Yong Shen (Columbia University Medical Center) Mena G. Kerolus (Columbia University Medical Center) Alex S. Ha (Columbia University Medical Center) Ian A. Buchanan (Columbia University Medical Center) Nathan J. Lee (Columbia University Medical Center) Eric Leung (Columbia University Medical Center) Meghan Cerpa (Columbia University Medical Center) Ronald A. Lehman (Columbia University Medical Center) Lawrence G. Lenke (Columbia University Medical Center)
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제3호
발행연도
2021.9
수록면
570 - 579 (10page)
DOI
10.14245/ns.2142384.192

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Objective: To evaluate the effect of coronal alignment on: (1) surgical invasiveness and operative complexity and (2) postoperative complications. Methods: A retrospective, cohort study of adult spinal deformity patients was conducted. Alignment groups were: (1) neutral alignment (NA): coronal vertical axis (CVA)≤3 cm and sagittal vertical axis (SVA)≤5 cm; (2) coronal malalignment (CM) only: CVA>3 cm; (3) Sagittal malalignment (SM) only: SVA>5 cm; and (4) coronal and sagittal malalignment (CCSM): CVA>3 cm and SVA>5 cm. Results: Of 243 patients, alignment groups were: NA 115 (47.3%), CM 48 (19.8%), SM 38 (15.6%), and CCSM 42 (17.3%). Total instrumented levels (TILs) were highest in CM (14.5±3.7) and CCSM groups (14±4.0) (p<0.001). More 3-column osteotomies (3COs) were performed in SM (21.1%) and CCSM (28.9%) groups than CM (10.4%) (p=0.003). CM patients had more levels instrumented (p=0.029), posterior column osteotomies (PCOs) (p<0.001), and TLIFs (p=0.002) than SM patients. CCSM patients had more TLIFs (p=0.012) and higher estimated blood loss (EBL) (p=0.003) than SM patients. CVA displayed a stronger relationship with TIL (p=0.002), EBL (p<0.001), and operative time (p<0.001) than SVA, which had only one significant association with EBL (p=0.010). Both SM/CCSM patients had higher readmissions (p=0.003) and reoperations (p<0.001) than CM patients. Conclusion: Amount of preoperative CM was a better predictor of surgical invasiveness than the amount of SM, despite 3COs more commonly performed in SM patients. CM patients had more instrumented levels, PCOs, and TLIFs than SM patients.

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