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10.08.2019 | Original Article

The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery

Zeitschrift:
European Spine Journal
Autoren:
Kazuma Murata, Yuji Matsuoka, Hirosuke Nishimura, Kenji Endo, Hidekazu Suzuki, Taichiro Takamatsu, Yasunobu Sawaji, Takato Aihara, Takuya Kusakabe, Asato Maekawa, Kengo Yamamoto, Kei Watanabe, Takashi Kaito, Hidetomi Terai, Koji Tamai, Atushi Tagami, Toshitaka Yoshii, Katsumi Harimaya, Kenichi Kawaguchi, Atsushi Kimura, Gen Inoue, Atsushi Nakano, Daisuke Sakai, Akihiko Hiyama, Shota Ikegami, Seiji Ohtori, Takeo Furuya, Sumihisa Orita, Shiro Imagama, Kazuyoshi Kobayashi, Katsuhito Kiyasu, Hideki Murakami, Katsuhito Yoshioka, Shoji Seki, Michio Hongo, Kenichiro Kakutani, Takashi Yurube, Yasuchika Aoki, Hiroshi Uei, Yasumitsu Ajiro, Masahiko Takahata, Hirooki Endo, Tetsuya Abe, Kazuyoshi Nakanishi, Kota Watanabe, Eijiro Okada, Naobumi Hosogane, Haruki Funao, Norihiro Isogai, Ken Ishii
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-019-06092-0) contains supplementary material, which is available to authorized users.

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Abstract

Purpose

Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.

Methods

We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.

Results

The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3; P < 0.001), perioperative complication (OR, 3.4; P = 0.006), absence of preoperative bone-modifying agent (BMA) administration (OR, 2.7; P = 0.03), and absence of postoperative recombinant human parathyroid hormone (rPTH) administration (OR, 3.9; P = 0.006) were significantly associated. In multivariate analysis, preoperative neurological deficit (OR, 4.6; P < 0.001), perioperative complication (OR, 3.4; P = 0.01), and absence of postoperative rPTH administration (OR, 3.9; P = 0.02) showed statistical significance.

Conclusions

Preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration were considered as predictors for postoperative poor ADL in patients with OVF. Neurological deficits and complications are often inevitable factors; therefore, rPTH is an important option for postoperative treatment for OVF.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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