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Erschienen in:

31.05.2024 | Original Article

Predictive role of FRAX© for postoperative proximal junctional kyphosis with vertebral fracture after adult spinal deformity surgery

verfasst von: Junya Katayanagi, Hiroki Konuma, Tsukasa Yanase, Hiroyuki Inose, Tomoyuki Tanaka, Takahiro Iida, Shingo Morishita, Tetsuya Jinno

Erschienen in: European Spine Journal | Ausgabe 7/2024

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Abstract

Purpose

To identify risk factors, including FRAX (a tool for assessing osteoporosis) scores, for development of proximal junctional kyphosis (PJK), defined as Type 2 in the Yagi–Boachie classification (bone failure), with vertebral fracture (VF) after surgery for symptomatic adult spinal deformity.

Methods

This was a retrospective, single institution study of 127 adults who had undergone corrective long spinal fusion of six or more spinal segments for spinal deformity and been followed up for at least 2 years. The main outcome was postoperative development of PJK with VF. Possible predictors of this outcome studied included age at surgery, BMI, selected radiographic measurements, bone mineral density, and 10-year probability of major osteoporotic fracture (MOF) as determined by FRAX. We also analyzed use of medications for osteoporosis. Associations between the selected variables and PJK with VF were assessed by the Mann–Whitney, Fishers exact, and Wilcoxon signed-rank tests, and Kaplan–Meier analysis, as indicated.

Results

Forty patients (31.5%) developed PJK with VF postoperatively,73% of them within 6 months of surgery. Statistical analysis of the selected variables found that only a preoperative estimate by FRAX of a > 15% risk of MOF within 10 years, pelvic tilt > 30° at first standing postoperatively and lower instrumented level (fusion terminating at the pelvis) were significantly associated with development of PJK with VF.

Conclusion

Preoperative assessment of severity of osteoporosis using FRAX provides an accurate estimate of risk of postoperative PJK with VF after surgery for adult spinal deformity.
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Metadaten
Titel
Predictive role of FRAX© for postoperative proximal junctional kyphosis with vertebral fracture after adult spinal deformity surgery
verfasst von
Junya Katayanagi
Hiroki Konuma
Tsukasa Yanase
Hiroyuki Inose
Tomoyuki Tanaka
Takahiro Iida
Shingo Morishita
Tetsuya Jinno
Publikationsdatum
31.05.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 7/2024
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-024-08309-3

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