Bone parameters in hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: A comparative cross-sectional study

Coussens, Marie; Banica, Thiberiu; Lapauw, Bruno; Wandele, Inge De; Rombaut, Lies; Malfait, Fransiska

doi:10.1016/j.bone.2022.116583

Cited by 5 publications

(1 citation statement)

References 26 publications

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“… 32 Coussens et al also found lower cortical bone mineral content and cortices in individuals with hypermobile EDS. 33 Poor bone health commonly manifests as osteoporosis, which is a risk factor for pseudarthrosis and instrument failure as a result of displaying diminished pullout strength and insertional torque. 34 , 35 This phenomenon is clinically warranted as pseudarthrosis has been shown to impede neck pain relief and is one of the most common indications for additional intervention after ACDF, accounting for up to 56% of revision cases.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Following Anterior Cervical Discectomy and Fusion in Patients With Ehlers-Danlos Syndrome

Chi

Raso

Tadepalli

et al. 2023

Global Spine Journal

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Study Design Retrospective database analysis. Objectives To study postoperative complication rates following anterior cervical discectomy and fusion (ACDF) in patients with Ehlers-Danlos syndrome (EDS) compared with patients without EDS. Methods The Mariner database was utilized to identify patients with EDS undergoing one or two level anterior cervical discectomy and fusion (ACDF). Postoperative short-term outcomes assessed included medical complications, readmissions, and ED-visits within 90 days of surgery. Additionally, surgical complications including wound complications, surgical site infection, one- and two-year anterior revision along with posterior revision, pseudarthrosis, and hardware failure within 2 years were assessed. Multivariate logistic regression was used to adjust for demographic variables, comorbidities and number of levels operated on. Results The present study identified 533 patients in the EDS group and 2634 patients in the matched control group. EDS patients undergoing ACDF are at an increased risk for 90-day major medical complications (OR 3.31; P < .001). EDS patients were also found to be associated with surgical complications including wound complications (OR 2.94; P < .001), surgical site infection (OR 8.60; P < .001) within 90 days, pseudarthrosis (OR 2.33; P < .001), instrument failure (OR 4.03; P < .001), anterior revision (OR 22.87; P < .001), and posterior revision (OR 3.17; P < .001) within 2 years. Conclusions EDS is associated with higher rates of both medical and surgical complications following ACDF. Spine surgeons should be cognizant of the increased risks in this population to provide appropriate preoperative counseling and enhanced perioperative medical management.

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