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Risk factors for acute proximal junctional kyphosis after adult spinal deformity surgery in preoperative motion analysis

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Abstract

Objective

This study aimed to examine which motion analysis parameters regarding the dynamic aspects and/or balance affect the development acute proximal junctional kyphosis (PJK) following adult spinal deformity (ASD) surgery.

Methods

A total of 90 consecutive patients were recruited prospectively, who underwent a corrective surgery for ASD with sagittal imbalance. According to the development of acute PJK within 6 months after surgery, the patients were divided into the PJK+ and PJK− groups. Before surgery, three-dimensional gait analyses were performed using a motion analysis system. The preoperative continuous and categorical variables were compared between the PJK+ and PJK− groups using independent t tests and chi-square tests, respectively. Finally, a multivariate logistic regression model was used to identify the risk factors and calculate the odds ratio (OR) for acute PJK.

Results

A total of 20 and 70 patients were classified into the PJK+ and PJK− groups, respectively. There were no differences in the spinopelvic radiologic parameters pre- and postoperatively between the PJK+ and PJK− groups. The PJK+ group showed a significantly higher mean anterior pelvic tilt (Ant-PT) angle in preoperative motion analysis than the PJK− group (P = 0.001 for both sides). Multivariate analysis identified the mean Ant-PT angle (P = 0.047; OR 1.127; 95% CI 1.002–1.267) as a significant risk factor for acute PJK.

Conclusion

Preoperative Ant-PT angle during walking was associated with a higher OR in acute PJK after surgery.

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Author notes

  1. Dae-Woong Ham and Heesoo Han have contributed equally to this work as a co-first author.

Authors and Affiliations

  1. Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea

    Dae-Woong Ham, Heesoo Han, Ho-Joong Kim, Sang-Min Park & Jin S. Yeom

  2. Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Bong-Soon Chang

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  1. Dae-Woong Ham
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Correspondence to Ho-Joong Kim.

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Ham, DW., Han, H., Kim, HJ. et al. Risk factors for acute proximal junctional kyphosis after adult spinal deformity surgery in preoperative motion analysis. Eur Spine J 30, 1215–1225 (2021). https://doi.org/10.1007/s00586-021-06830-3

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  • DOI: https://doi.org/10.1007/s00586-021-06830-3

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