Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: A systematic review and meta-analysis

IF 1.1 4区医学 Q3 ORTHOPEDICS

Acta orthopaedica et traumatologica turcica Pub Date : 2022-05-01 DOI:10.5152/j.aott.2022.21255

Xuexin Han, Jiabin Ren

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引用次数: 3

Abstract

Objective: This study aimed to conduct a systematic review and meta-analysis to assess the risk factors for proximal junctional kyphosis after the correction surgery of adult spinal deformity. Methods: Relevant studies were systematically retrieved from databases including Cochrane Library, PubMed, and Embase. Based on inclusion and exclusion criteria, literature screening, quality evaluation, and data extraction were conducted. Analysis was performed with Revman 5.3 software. Results: Sixteen studies with 2388 patients, covering 905 cases with proximal junctional kyphosis and 1483 cases without proximal junctional kyphosis, were included in the study. The high-risk factors for the development of proximal junctional kyphosis were found to be high body mass index, osteoporosis, severe fatty infiltration of paravertebral muscles, small functional area of paravertebral muscles, lumbar lordosis over-correction, lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment, and pelvic fixation. The results were statistically significant. Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment. Level of Evidence: Level IV, Therapeutic Study

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成人脊柱畸形矫形术后近端关节后凸的危险因素:一项系统回顾和荟萃分析

目的:本研究旨在通过系统回顾和荟萃分析来评估成人脊柱畸形矫形术后近端关节后凸的危险因素。方法:系统地从Cochrane Library、PubMed、Embase等数据库中检索相关研究。根据纳入和排除标准，进行文献筛选、质量评价和数据提取。采用Revman 5.3软件进行分析。结果:共纳入16项研究2388例患者，包括905例近端交界面后凸和1483例无近端交界面后凸。高体质指数、骨质疏松、椎旁肌肉严重脂肪浸润、椎旁肌肉功能面积小、腰椎前凸过度矫正、近段椎体和胸腰段上固定椎体缺乏韧带加固装置、骨盆固定是发生近端交界性后凸的高危因素。结果具有统计学意义。结论:本研究证据显示，成人脊柱畸形矫形术后近端结缔组织后凸并发症的独立危险因素为体重指数高、骨质疏松、椎旁肌肉严重退变、腰椎前凸过度矫形、骨盆固定融合、近端椎体和胸腰段上固定椎体缺乏韧带加固装置。证据等级:IV级，治疗性研究

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来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.