Risk factor analysis for predicting vertebral body re-collapse after posterior instrumented fusion in thoracolumbar burst fracture

Jang, Hae‐Dong; Bang, Chungwon; Lee, Jae Chul; Soh, Jaewan; Choi, Sung-Woo; Cho, Hyeung-Kyu; Shin, Byung-Joon

doi:10.1016/j.spinee.2017.07.168

Cited by 30 publications

(29 citation statements)

References 19 publications

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“…Our results showed that preoperative VAS score could not be used to predict the risk of KR. The reason was that VAS score had strong subjectivity with many influence factors, which made its accuracy limited [6,7]. Pellise et al [26] pointed out that LSC score was positively correlated with correction loss.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the parameters were collected before implant removal and at last follow-up. The following radiological parameters [6,7,10] were evaluated: Cobb angle (CA) was measured between the inferior endplate (IE) of the lower adjacent vertebra (LAV) and the SE of the upper adjacent vertebra (UAV); vertebral wedge angle (VWA) was the angle between the IE and the SE of fractured vertebra;…”

Section: Radiological Measurementsmentioning

confidence: 99%

“…However, it is also associated with common complications, such as failure of the instrumentation, the recurrence of kyphosis (KR) and sagittal spinal imbalance [4,5]. Jang et al [6] reported that predictors of vertebra re-collapse for thoracolumbar burst fracture were age and the loss of preoperative body height. Nevertheless, they combined long-segment pedicle instrumentation with short-segment pedicle instrumentation in the study.…”

Section: Introductionmentioning

confidence: 99%

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Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Zhang

Sun

et al. 2019

Preprint

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KEYWORDSRisk factors; kyphosis reoccurrence; posterior short-segment fixation; thoracolumbar burst fracture. AbstractBackground: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds. Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively. Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% (P < 0.001, respectively), and UIVA (P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal. Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.

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Section: Discussionmentioning

confidence: 99%

Section: Radiological Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Zhang

Sun

et al. 2019

Preprint

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“…The inclusion criteria were as follows: Thoracolumbar Injury Classi cation and Severity (TLICS) score was more than 4; kyphosis was more than 15°; anterior vertebral height was less than 50% [3,7,8]. The exclusion criteria were as follows: Multiple contiguous fractures or non-contiguous fractures; bone mineral density (BMD) of the thoracolumbar spine (test results on the day of admission) was at least 2.5 SD below the mean of young normal men; pathological fracture such as tumor, ankylosing spondylitis, in ammatory arthritis; posterior fusion or posterolateral fusion, and laminectomy in the operation; neurological de cit, obsolete thoracolumbar fracture, previous history of spinal surgery [3,[6][7][8]. Finally, 55 patients were excluded because of the loss of follow-up.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Sun

Chen

Sun³

et al. 2020

Preprint

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Background: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds. Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively. Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% ( P < 0.001, respectively), and UIVA ( P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal. Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.

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“…Vertebral volume is considered to be an independent LVF risk factor. 31 However, no studies have evaluated the dorsal and ventral T12V body height as a morphological parameter for prediction of LVF. T12V is unique in that is represents a transition from thoracic to lumbar vertebrae.…”

Section: Introductionmentioning

confidence: 99%

<p>Dorsal and ventral thoracic 12 vertebra body height is associated with incident lumbar vertebral fracture in postmenopausal osteoporotic women</p>

Bang

Lee

Kang

et al. 2019

CIA

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Purpose: We measured dorsal and ventral thoracic 12 vertebral (T12V) body heights as a way to predict lumbar vertebral fracture (LVF) in postmenopausal women. MRI of dorsal and ventral T12V body heights has not yet been used to investigate their association with LVF. We hypothesized that the dorsal and ventral T12V body height are important morphologic parameters in the prediction of LVF. Patients and methods: In total, 80 osteoporotic patients with LVF (LVF group) and 80 osteoporotic patients without LVF (control group) were examined by MRI at the lumbothoracic level. Sagittal T2-weighted MRI images in the T12 level were obtained from all subjects. We analyzed both the dorsal and ventral T12V body height. The difference in dorsal and ventral body heights of the control and LVF patients was calculated at the T12V level. Results: The average dorsal T12V body height was 21.25±1.64 mm in the control group and 20.11±1.49 mm in the LVF group. The average ventral T12V body heights were 19.51±1.54 mm and 17.62±1.95 mm, respectively. The LVF group had significantly lower dorsal and ventral T12V body heights (both P,0.001). ROC curve analysis showed the best cutoff value for dorsal T12V body height value of 20.74 mm, with 62.5% sensitivity and 60.0% specificity. The best cutoff point of ventral T12V body height was 18.76 mm, with 68.8% sensitivity and 67.5% specificity. Conclusion: This study confirmed the association between dorsal and ventral T12V body height and occurrence of LVF in postmenopausal women with osteoporosis. Dorsal and ventral T12V body height were both significantly associated with LVF, with ventral T12V body height being a more sensitive measurement parameter. Thus, to predict risk of LVF in patients, the treating physician should carefully inspect the ventral T12V body height.

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Risk factor analysis for predicting vertebral body re-collapse after posterior instrumented fusion in thoracolumbar burst fracture

Cited by 30 publications

References 19 publications

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

<p>Dorsal and ventral thoracic 12 vertebra body height is associated with incident lumbar vertebral fracture in postmenopausal osteoporotic women</p>

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