当前位置： SCI文献检索 > SPINE期刊下所有文献 > Loss of Pelvic Incidence Correction After Long Fusion Using Iliac Screws for Adult Spinal Deformity: Cause and Effect on Clinical Outcome.

Loss of Pelvic Incidence Correction After Long Fusion Using Iliac Screws for Adult Spinal Deformity: Cause and Effect on Clinical Outcome.

Abstract：

STUDY DESIGN:Retrospective observational cohort study. OBJECTIVE:To determine change in pelvic incidence (PI) and loss of correction after long fusion with iliac screws, the effect of iliac screw loosening, and global alignment according to postoperative PI. SUMMARY OF BACKGROUND DATA:Posterior long fixation and fusion of the thoracic to the ilium is one of the most common surgical treatments for adult spinal deformity (ASD). Long fusion to the sacrum with iliac screws decreases the PI by 3.9° after surgery. PI decreases once by long fusion with iliac screws. However, if the iliac screw loosens, PI may cause correction loss and return to the preoperative PI. METHODS:We retrospectively reviewed the cases of 69 consecutive patients with ASD. Their mean age (SD) was 70.5 (7.3) years, 12% were male. PI was evaluated preoperatively, early- and 1-year postoperatively. We compared change in PI with and without loosening of iliac screws, spinopelvic parameters according to 1-year-postoperative PI. RESULTS:PI decreased significantly from 51.8° (9.3°) to 48.1° (9.5°) early postoperatively (P < 0.01). PI increased significantly from 48.1° (9.5°) to 49.6° (9.7°) within a year postoperatively (P < 0.01). Significant loss of PI correction (2.3°, P < 0.01) occurred within a year after surgery in patients with iliac screw loosening and was significantly different from the PI loss in those without screw loosening (53.9°, 48.2°, P = 0.03). Pelvic tilt, sacral slope, C7 sagittal vertical axis, global tilt, and T1 pelvic angle were significantly smaller in the group with PI <50° postoperatively at 1 year compared with the group with PI >50°. CONCLUSION:Although PI decreases after long fusion surgery with iliac screws, significant correction loss appears within a year. Loosening of iliac screws may exacerbate this loss. Patients with PI <50° postoperatively were able to maintain better global alignment. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Oba H,Ebata S,Takahashi J,Ikegami S,Koyama K,Haro H,Kato H,Ohba T

doi

10.1097/BRS.0000000000002775

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

195-202

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-201902010-00012

journal_volume

pub_type

杂志文章

在线工具

Loss of Pelvic Incidence Correction After Long Fusion Using Iliac Screws for Adult Spinal Deformity: Cause and Effect on Clinical Outcome.