Incidence and Risk Factors for Postoperative Hip Displacement Following Spinal Fusion in Nonambulant Patients With Spastic Neuromuscular Scoliosis.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-03-06 DOI:10.1097/BSD.0000000000001782

Yuki Taniguchi, Daiki Urayama, Keita Okada, Sayumi Yabuki, Ayato Nohara, Takashi Ono, Yoshitaka Matsubayashi, Hiroyuki Nakarai, Koji Nakajima, Hideki Nakamoto, So Kato, Sakae Tanaka, Yasushi Oshima

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Abstract

Study design: Retrospective multicenter cohort study.

Objective: To investigate the incidence and risk factors of postoperative hip displacement following spinal fusion in nonambulant patients with spastic neuromuscular scoliosis.

Summary of background data: In patients with spastic neuromuscular disorders, spinal deformity, and hip displacement mutually influence each other; however, little is known about the clinical impact of spinal fusion on the incidence of hip displacement.

Methods: We retrospectively analyzed nonambulant patients with spastic neuromuscular disorders undergoing primary fusion with a minimum follow-up of 1 year. The primary outcome was new postoperative hip displacement. To identify potential risk factors for postoperative hip displacement, an association analysis was conducted.

Results: We identified 67 eligible patients (29 males and 38 females) with a mean age of 14.1 years and a mean follow-up period of 49.4 months. Overall, 11 cases of postoperative hip displacement (10 up hip, and 1 down hip) were identified in 11 patients (16.4%). Patients with hip displacement were significantly more skeletally immature at surgery, had a significantly larger preoperative curve magnitude (115.6 vs. 97.5 degrees), larger correction of the Cobb angle (71.0 vs. 56.8 degrees), larger preoperative pelvic obliquity (36.2 vs. 24.3 degrees), and included a significantly higher proportion of cases with pelvic fixation (P=0.03). Compared with patients with nondislocated stable up hip joints, 10 patients with new up hip displacement had a significantly higher preoperative migration percentage (MP) in the up hip (40.6 vs. 31.4, P=0.047). Receiver operating characteristic curve analysis revealed that the optimal cutoff value of the preoperative MP of the up hip for predicting postoperative displacement was 28.8 (sensitivity, 90.0%; specificity, 47.8%).

Conclusions: When performing spinal fusion in patients with spastic neuromuscular disorders, especially in those with identified potential risk factors, patients and their caregivers should be informed preoperatively about the possibility of subsequent hip displacement.

Level of evidence: Level III.

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.