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Surgical Correction in Patients with Lumbar Degenerative Kyphosis Who Had Low Bone Mineral Density: An Analysis of 40 Patients with a Minimum Follow-Up of Two Years

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Author(s)
Ki Tack KimChris Yin Wei ChanSang Hun LeeDae Seok HuhEun Seok Son
Keimyung Author(s)
Son, Eun Seok
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Asian Spine Journal
Issued Date
2015
Volume
9
Issue
1
Abstract
Study Design: Retrospective study.
Purpose: To investigate influence of bone mineral density (BMD) on the surgical correction of lumbar degenerative kyphosis (LDK).
Overview of Literature: No studies so far have reported the influence of BMD on the surgical correction of LDK.
Methods: Forty LDK patients with more than 2 years follow-up were studied. Pelvic incidence (PI), pelvic tilt, sacral slope, sagittal
vertical axis (SVA), lumbar lordosis (LL), and thoracic kyphosis were measured preoperatively, immediate postoperatively and at final
follow-up. Adverse outcomes: proximal adjacent fractures, sagittal decompensation, pseudoarthrosis, and cage subsidence were
documented.
Results: There were 37 females and 3 males. Average age was 65.1±4.5 years and mean follow-up was 34.2±16.7 months. 42.5%
were Takemitsu type 3 curves, 27.5% type 2, 20.0% type 4 and 10.0% type 1. 37.5% had osteopenia, 40.0% osteoporosis and
22.5% had severe osteoporosis. SVA improved from 237.0±96.7 mm preoperatively to 45.3±41.8 mm postoperatively (p =0.000). LL
improved from 10.5°±14.7° to –40.6°±10.9° postoperatively (p =0.000). At final follow-up SVA deteriorated to 89.8±72.2 mm and LL to
34.7°±15.8° (p =0.000). The association between late sagittal decompensation, pseudoarthrosis, or proximal adjacent fractures and
osteoporosis was insignificant. The difference between immediate postoperative LL and PI (PIDiff) had a significant association with
sagittal decompensation and pseudoarthrosis.
Conclusions: Osteoporosis did not influence the degree of correction, late sagittal decompensation, proximal adjacent fractures, and
pseudoarthrosis in LDK. PIDiff had a significant association with sagittal decompensation and pseudoarthrosis.
Keywords: Lumbar degenerative kyphosis; Bone mineral density; Surgery; Outcome; Osteoporosis
Keimyung Author(s)(Kor)
손은석
Publisher
School of Medicine
Citation
Ki Tack Kim et al. (2015). Surgical Correction in Patients with Lumbar Degenerative Kyphosis Who Had Low Bone Mineral Density: An Analysis of 40 Patients with a Minimum Follow-Up of Two Years. Asian Spine Journal, 9(1), 65–74. doi: 10.4184/asj.2015.9.1.65
Type
Article
ISSN
1976-1902
DOI
10.4184/asj.2015.9.1.65
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35130
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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