Risk Factors for Proximal Junctional Kyphosis
10.3969/j.issn.1006-9771.2017.05.026
- VernacularTitle:近端交界性后凸的危险因素分析
- Author:
Bo ZHENG
;
Fei WANG
;
Zhicheng ZHANG
;
Xiaofeng ZHAO
;
Daoyu HUANG
;
Fang LI
- Keywords:
degenerative lumbar spinal disease;
proximal junctional kyphosis;
posterior long segmental lumbar fusion;
risk factors
- From:
Chinese Journal of Rehabilitation Theory and Practice
2017;23(5):607-611
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of proximal junctional kyphosis (PJK) after posterior long segmental lumbar fusion for degenerative lumbar disease. Methods From October, 2012 to July, 2014, 118 degenerative lumbar disease patients who accepted posteri-or long segmental fusion and followed up at least 1.5 years were reviewed. All the PJK were evaluated with X-ray. Results Sixty-six pa-tients completed the follow-up (mean of 3.2 years), in which 12 patients with PJK (PJK group), and the others without (non-PJK group, n=54). There was significant difference in body mass index, bone density and the last Oswestry Disability Index scores (t>2.194, P<0.05) be-tween both groups, as well as the rate of the upper instrumented vertebra (UIV) located in the thoracolumbar segment (T11-L1) (χ2=4.63, P<0.05). The PJK angle was more in PJK group than non-PJK group pre-surgery, post-surgery and finally (t>3.862, P<0.001). Binary Logistic regression showed that osteoporosis (OR=5.328, 95% CI: 1.110~25.581), UIV located in the thoracolumbar segment (T11-L1) (OR=6.239, 95%CI:1.157~33.648) and the pre-surgery PJK angle>10° (OR=5.789, 95%CI:1.075~31.183) were the independent risk factors of PJK. Conclusion Osteoporosis, UIV located in the thoracolumbar segment (T11-L1) and the pre-surgery PJK angle>10° are risk factors of PJK af-ter posterior long segmental lumbar fusion.
