Comparative advantages of activities with lumbosacral preservation for adult spinal deformity surgery: a retrospective Japanese cohort study.

IF 2.3 Q2 ORTHOPEDICS
Asian Spine Journal Pub Date : 2024-10-01 Epub Date: 2024-10-22 DOI:10.31616/asj.2024.0217
Yoshinori Ishikawa, Takashi Kobayashi, Eiji Abe, Ryo Shoji, Naohisa Miyakoshi
{"title":"Comparative advantages of activities with lumbosacral preservation for adult spinal deformity surgery: a retrospective Japanese cohort study.","authors":"Yoshinori Ishikawa, Takashi Kobayashi, Eiji Abe, Ryo Shoji, Naohisa Miyakoshi","doi":"10.31616/asj.2024.0217","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>This study aimed to demonstrate the advantages of preservation of the lumbosacral segment (LSS) in adult spinal deformity (ASD) surgery.</p><p><strong>Overview of literature: </strong>Sacroiliac foundation enables sufficient restoration in ASD surgery; however, it could result in poor mobility. Thus, whether LSS provides better activities is still unknown.</p><p><strong>Methods: </strong>Among 399 patients who underwent ASD surgery, 62 (≥5 levels fused, >2-year follow-up) underwent fusion from T9-10 to L5 (group L, n=21) or to S2-alar-iliac (group S, n=41). Spinal alignments, Scoliosis Research Society (SRS)-22 scores, performance of activities (clipping toenail, wiping buttock, and wearing socks), proximal and distal junctional failure (PJF+DJF), rod fractures (RFs), and overall revision rates (RRs) were compared between the groups.</p><p><strong>Results: </strong>Group L included younger patients and had longer follow-ups when compared with group S. Although the preoperative pelvic incidence and SRS sagittal modifiers were better in group L, postoperative spinal restorations were nonpathological in both groups. Both groups showed similar deformity progression at the 2-year follow-up; however, group L had lower SRS-22 pain scores. Although \"wiping buttocks\" did not differ between the groups, the performance of \"clipping toenails\" and \"wearing socks\" was poorer in group S at 2 years (possible, group S; 40% vs. group L; 85%-90%). The RRs did not differ between the groups; however, the PJF+DJF rate was higher in group L. DJF was not observed in group S, but occurrence of RFs was noted.</p><p><strong>Conclusions: </strong>Although poorer SRS-22 pain scores might be related to lumbosacral mobility, sufficient restoration, equivalent deformity progression, and similar RRs with better activity imply that lumbosacral preservation should be considered in younger patients with moderate deformities.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538815/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Spine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31616/asj.2024.0217","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Study design: Retrospective cohort study.

Purpose: This study aimed to demonstrate the advantages of preservation of the lumbosacral segment (LSS) in adult spinal deformity (ASD) surgery.

Overview of literature: Sacroiliac foundation enables sufficient restoration in ASD surgery; however, it could result in poor mobility. Thus, whether LSS provides better activities is still unknown.

Methods: Among 399 patients who underwent ASD surgery, 62 (≥5 levels fused, >2-year follow-up) underwent fusion from T9-10 to L5 (group L, n=21) or to S2-alar-iliac (group S, n=41). Spinal alignments, Scoliosis Research Society (SRS)-22 scores, performance of activities (clipping toenail, wiping buttock, and wearing socks), proximal and distal junctional failure (PJF+DJF), rod fractures (RFs), and overall revision rates (RRs) were compared between the groups.

Results: Group L included younger patients and had longer follow-ups when compared with group S. Although the preoperative pelvic incidence and SRS sagittal modifiers were better in group L, postoperative spinal restorations were nonpathological in both groups. Both groups showed similar deformity progression at the 2-year follow-up; however, group L had lower SRS-22 pain scores. Although "wiping buttocks" did not differ between the groups, the performance of "clipping toenails" and "wearing socks" was poorer in group S at 2 years (possible, group S; 40% vs. group L; 85%-90%). The RRs did not differ between the groups; however, the PJF+DJF rate was higher in group L. DJF was not observed in group S, but occurrence of RFs was noted.

Conclusions: Although poorer SRS-22 pain scores might be related to lumbosacral mobility, sufficient restoration, equivalent deformity progression, and similar RRs with better activity imply that lumbosacral preservation should be considered in younger patients with moderate deformities.

成人脊柱畸形手术中保留腰骶部活动的比较优势:一项回顾性日本队列研究。
研究设计目的:本研究旨在证明在成人脊柱畸形(ASD)手术中保留腰骶段(LSS)的优势:文献综述:骶髂基础在脊柱畸形(ASD)手术中可实现充分的恢复,但可能导致活动能力差。因此,LSS 是否能提供更好的活动能力仍是未知数:在接受ASD手术的399例患者中,62例(融合≥5级,随访>2年)接受了从T9-10到L5的融合(L组,21例)或到S2-髂骨-髂骨的融合(S组,41例)。对两组患者的脊柱排列、脊柱侧弯研究协会(SRS)-22评分、活动能力(剪脚趾甲、擦屁股和穿袜子)、近端和远端连接失败(PJF+DJF)、杆骨折(RFs)和总体翻修率(RRs)进行了比较:虽然 L 组患者的术前骨盆发生率和 SRS 矢状面改良剂更佳,但两组患者的术后脊柱修复均无病理改变。在两年的随访中,两组的畸形进展情况相似;但 L 组的 SRS-22 疼痛评分较低。虽然 "擦屁股 "在两组之间没有差异,但在两年后,S 组在 "剪脚趾甲 "和 "穿袜子 "方面的表现较差(可能,S 组;40% 对 L 组;85%-90%)。S组未观察到DJF,但出现了RF:结论:虽然SRS-22疼痛评分较差可能与腰骶部活动度有关,但充分的恢复、同等的畸形进展和相似的RRs以及更好的活动度意味着,对于中度畸形的年轻患者,应考虑保留腰骶部。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信