Occupancy Rate of Pedicle Screw Below 80% is a Risk Factor for Upper Instrumented Vertebral Fracture After Adult Spinal Deformity Surgery

Retrospective study. To determine whether an occupancy rate of a pedicle screw (ORPS) <80% in an upper instrumented vertebra (UIV) is a risk factor for UIV fracture (UIVF). The ratio of the length of the pedicle screw to the anteroposterior diameter of the vertebral body at the UIV is defined as...

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Vydáno v:Spine (Philadelphia, Pa. 1976) Ročník 48; číslo 12; s. 843
Hlavní autoři: Oe, Shin, Yamato, Yu, Hasegawa, Tomohiko, Yoshida, Go, Banno, Tomohiro, Arima, Hideyuki, Ide, Koichirou, Yamada, Tomohiro, Nakai, Keiichi, Kurosu, Kenta, Matsuyama, Yukihiro
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 15.06.2023
Témata:
Adult
Aged
Humans
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - injuries
Lumbar Vertebrae - surgery
Pedicle Screws - adverse effects
Retrospective Studies
Risk Factors
Spinal Fractures - diagnostic imaging
Spinal Fractures - epidemiology
Spinal Fractures - surgery
Spinal Fusion - adverse effects
Spinal Fusion - methods
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - injuries
Thoracic Vertebrae - surgery
ISSN:1528-1159, 1528-1159
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Shrnutí:Retrospective study. To determine whether an occupancy rate of a pedicle screw (ORPS) <80% in an upper instrumented vertebra (UIV) is a risk factor for UIV fracture (UIVF). The ratio of the length of the pedicle screw to the anteroposterior diameter of the vertebral body at the UIV is defined as ORPS. Previous studies showed that the stress on the UIV is reduced to the greatest degree when ORPS is >80%. However, it remains unclear whether these results are clinically valid. A total of 297 patients who had undergone adult spinal deformity surgery were included in the study. The group with an ORPS ≥80% and <80% was defined as the H (n = 198) and L (n = 99) group, respectively. Propensity score matching and logistic regression analysis were used to evaluate the association between ORPS and the development of UIVF adjusting for confounders. The mean age of both groups was 69 years. The average ORPS in the L and H groups was 70% and 85%, respectively. The incidence of UIVF was 30% in group L and 15% in group H ( P < 0.01). In addition, the 99 patients in group H were subdivided into 2 groups according to whether the screws penetrated the anterior wall of the vertebral body: 68 patients had no penetration (group U ), whereas 31 patients showed evidence of penetration (group B ). A total of 10% and 26% of the patients in the U and B groups, respectively, experienced UIVF ( P < 0.05). Logistic regression analysis indicated that ORPS <80% was significantly associated with UIVF ( P = 0.007, odds ratio: 3.9, 95% CI 1.4-10.5). To reduce UIVF, screw length should be set with a target ORPS of 80% or higher. If the screw penetrates the anterior wall of the vertebral body, the risk of UIVF is greater.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1528-1159
1528-1159
DOI:10.1097/BRS.0000000000004661