Thoracolumbar Junction Orientation: A Novel Guide for Sagittal Correction and Proximal Junctional Kyphosis Prediction in Adult Spinal Deformity Patients
DC Field | Value | Language |
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dc.contributor.author | Moon, Hong Joo | - |
dc.contributor.author | Bridwell, Keith H. | - |
dc.contributor.author | Theologis, Alekos A. | - |
dc.contributor.author | Kelly, Micheal P. | - |
dc.contributor.author | Lertudomphonwanit, Thamrong | - |
dc.contributor.author | Lenke, Lawrence G. | - |
dc.contributor.author | Gupta, Munish C. | - |
dc.date.accessioned | 2021-08-30T04:33:46Z | - |
dc.date.available | 2021-08-30T04:33:46Z | - |
dc.date.created | 2021-06-19 | - |
dc.date.issued | 2021-01 | - |
dc.identifier.issn | 0148-396X | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/50215 | - |
dc.description.abstract | BACKGROUND: Novel radiographic sagittal parameters of the thoracolumbar junction orientation (TLJO, thoracolumbar slope [TLS] and thoracolumbar tilt [TLT]) have been introduced and correlated with lumbopelvic parameters and thoracic kyphosis. OBJECTIVE: To determine a predictive model for reciprocal thoracic kyphosis and proximal junctional kyphosis (PJK) based on the TLJO. METHODS: A total of 127 patients who had fusion fromsacrum to T10-L2 from 2004 to 2014 were reviewed. TK (T5-T12), PI, SS, PT, LL, and proximal junctional angle (PJA) were measured preoperatively, 6 wk postoperatively, and at final follow-up. TLJO was measured by TLS and TLT. Changes between time points were determined (preop-6 wk = Delta Parameter(Pre6wk) and preop-final follow/up= Delta Parameter(PreFinal)). Scoliosis Research Society (SRS) and Oswestry Disability Index (ODI) questionnaires were evaluated at final follow-up. Patients were divided into 2 groups based on the presence of PJK (Delta PJA(PreFinal) >15 degrees). Independent t-tests and receiver operating characteristic (ROC) curves were used to investigate the significance of differences and cut-off values. Pearson correlations and linear regressions were used to analyze the entire cohort to determine the relationship between the changes in parameters. RESULTS: Compared to patients without PJK (n = 100), those with PJK (n = 27) had significantly lower SRS scores and significantly greater Delta TKPreFinal, Delta LLPre6wk, and Delta TLSPre6wk. To maintain in the nonPJK group, ROC curves demonstrated a cut-off value of -9.4 degrees for Delta TLSPre6wk. PJK was significantly correlated with Delta TKPreFinal and Delta TLSPre6wk. The linear correlation revealed that Delta TLSPre6wk < -25.3 degrees is the risk factor of PJK > 15 degrees. CONCLUSION: As change of TLS reflects lumbopelvic realignment and influences reciprocal TK, reducing the change of TLS may be a sagittal realignment guideline to reduce the risk of PJK. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | OXFORD UNIV PRESS INC | - |
dc.subject | SURGICAL-OUTCOMES | - |
dc.subject | LUMBAR LORDOSIS | - |
dc.subject | SURGERY | - |
dc.subject | ALIGNMENT | - |
dc.subject | POSITION | - |
dc.title | Thoracolumbar Junction Orientation: A Novel Guide for Sagittal Correction and Proximal Junctional Kyphosis Prediction in Adult Spinal Deformity Patients | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Moon, Hong Joo | - |
dc.identifier.doi | 10.1093/neuros/nyaa311 | - |
dc.identifier.scopusid | 2-s2.0-85098531717 | - |
dc.identifier.wosid | 000606986200029 | - |
dc.identifier.bibliographicCitation | NEUROSURGERY, v.88, no.1, pp.55 - 62 | - |
dc.relation.isPartOf | NEUROSURGERY | - |
dc.citation.title | NEUROSURGERY | - |
dc.citation.volume | 88 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 55 | - |
dc.citation.endPage | 62 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Neurosciences & Neurology | - |
dc.relation.journalResearchArea | Surgery | - |
dc.relation.journalWebOfScienceCategory | Clinical Neurology | - |
dc.relation.journalWebOfScienceCategory | Surgery | - |
dc.subject.keywordPlus | SURGICAL-OUTCOMES | - |
dc.subject.keywordPlus | LUMBAR LORDOSIS | - |
dc.subject.keywordPlus | SURGERY | - |
dc.subject.keywordPlus | ALIGNMENT | - |
dc.subject.keywordPlus | POSITION | - |
dc.subject.keywordAuthor | Lumbar degenerative kyphosis | - |
dc.subject.keywordAuthor | Proximal junctional kyphosis | - |
dc.subject.keywordAuthor | Reciprocal change | - |
dc.subject.keywordAuthor | Thracolumbar junction orientation | - |
dc.subject.keywordAuthor | Thoracolumbar slope | - |
dc.subject.keywordAuthor | Sagittal alignment | - |
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