是否应该惧怕 C7-T1 交界处?T1上部器质性椎骨对近端交界性脊柱后凸发展的影响

IF 1.6 Q3 CLINICAL NEUROLOGY
Carlos Monroig-Rivera, Ingrid Okonta, Jennifer M Bauer, Amit Jain, Firoz Miyanji, Stefan Parent, Peter Newton, V Salil Upasani, Patrick Cahill, Daniel Sucato, Paul D Sponseller, Amer Samdani, D'Marfeivel McLean, Jaysson T Brooks
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引用次数: 0

摘要

目的:在 AIS 中,近端交界性脊柱后凸是一种不常见的并发症;然而,在 C7-T1 交界处近端结束融合对未来 PJK 发展的影响仍不明确。本研究的目的是确定 UIV 为 T1 的 AIS 患者与 UIV 为 T2 的 AIS 患者在随访 5 年后的 PJK 发生率:对接受过 PSF 且随访至少 5 年的前瞻性多中心 AIS 患者数据库进行了查询。将 UIV 为 T1 的患者(n = 29)与 UIV 为 T2 的患者(n = 58)进行比较。PJK 的定义是近端交界角 (PJA) > 10 度:结果:T1和T2 UIV组别在术前T2-T12椎体后凸或骨盆发生率方面没有差异;但术前,T1 UIV患者的PJA明显降低,为- 3° ± 4.5°,而T2 UIV患者为1.6° ± 6.5°(P = 0.0014)。在 5 年的随访中,没有 T1 UIV 患者出现 PJK,而 16% 的 T2 UIV 患者出现了 PJK(p = 0.025)。T2 UIV 组群中没有患者因 PJK 而需要进行翻修手术。SRS22总分没有差异,但在5年的随访中,T2 UIV患者的疼痛域评分(4.4 ± 0.6)优于T1 UIV患者(4.0 ± 0.6; p = 0.004):结论:虽然 T1 UIV 在 AIS 中并不常见,但在 5 年的随访中,T1 UIV 并未导致 PJK,也未导致患者报告的结果评分发生有临床意义的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Should the C7-T1 Junction Be Feared? The Effect of a T1 Upper Instrumented Vertebra on Development of Proximal Junctional Kyphosis.

Purpose: Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.

Methods: A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up. Patients with a T1 UIV (n = 29) were compared to those with a T2 UIV (n = 58). PJK was defined as a proximal junctional angle (PJA) > 10 degrees.

Results: There was no difference between the T1 and T2 UIV cohorts in preoperative T2-T12 kyphosis or pelvic incidence; however preoperatively, T1 UIV patients had a significantly decreased PJA at - 3° ± 4.5° as compared to T2 UIV patients 1.6° ± 6.5° (p = 0.0014). No patients with a T1 UIV experienced PJK at 5-years of follow-up, while 16% of patients with a T2 UIV experienced PJK (p = 0.025). No patients in the T2 UIV cohort required revision surgeries for their PJK. There was no difference found in total SRS22 scores, however at 5 years of follow-up, T2 UIV patients had better Pain domain scores (4.4 ± 0.6) vs T1 UIV patients (4.0 ± 0.6; p = 0.004).

Conclusion: While T1 is an uncommon UIV in AIS, at 5 years of follow-up, a T1 UIV did not result in PJK, nor did it result in a clinically significant change in patient-reported outcome scores.

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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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