The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients.
10.4055/jkoa.2017.52.1.83
- Author:
Dong Hyun LEE
1
;
Sung Soo KIM
;
Jung Hoon KIM
;
Dong Ju LIM
;
Byung Wan CHOI
;
Jin Hwan KIM
;
Jin Hyok KIM
;
Byung Ook PARK
Author Information
1. Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea. sskim@paik.ac.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
osteoporosis;
spinal fusion;
pedicle screws
- MeSH:
Aged*;
Bone Diseases;
Femur;
Follow-Up Studies;
Humans;
Hydrogen-Ion Concentration;
Kyphosis;
Miners;
Osteoporosis;
Pedicle Screws*;
Retrospective Studies;
Spinal Fusion
- From:The Journal of the Korean Orthopaedic Association
2017;52(1):83-91
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. MATERIALS AND METHODS: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). RESULTS: The average age was 72.4 years (65–83 years). The average fusion segment was 4.6 segments (3–6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. CONCLUSION: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.
