Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis
Abstract Objective Our study aimed to assess the effectiveness of the simplified S1 vertebral bone quality (VBQ) score in predicting the incidence of proximal junctional kyphosis (PJK) after surgery for degenerative lumbar scoliosis (DLS). Methods We reviewed 122 patients with DLS who underwent post...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-04722-y |
| _version_ | 1797209196455788544 |
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| author | Wei Deng Yue Zhou Qingsong Zhou Yong Yin Yueming Song Ganjun Feng |
| author_facet | Wei Deng Yue Zhou Qingsong Zhou Yong Yin Yueming Song Ganjun Feng |
| author_sort | Wei Deng |
| collection | DOAJ |
| description | Abstract Objective Our study aimed to assess the effectiveness of the simplified S1 vertebral bone quality (VBQ) score in predicting the incidence of proximal junctional kyphosis (PJK) after surgery for degenerative lumbar scoliosis (DLS). Methods We reviewed 122 patients with DLS who underwent posterior lumbar decompression and long-segment fusion surgery in our hospital from January 2016 to December 2020. The patients were classified into PJK group and non-PJK group. S1 VBQ scores are determined by signal intensity measurements taken from the mid-sagittal plane of T1-weighted non-contrast MRI. Logistic regression analysis was used to identify factors associated with PJK. Receiver-operating characteristic curve (ROC) analysis was used to evaluate the value of S1 VBQ score in predicting pedicle PJK after DLS. Results 122 DLS patients (90 females and 32 males) met the inclusion criteria. In addition, 27 patients (22.13%) had PJK at the time of last follow-up. VBQ was higher in PJK patients than non-PJK patients (3.58 ± 0.67 vs. 3.08 ± 0.54, p < 0.001). Preoperatively, patients in the PJK group had a greater TLK than those in the non-PJK group (20.00 ± 6.22 vs. 16.86 ± 5.38, p = 0.011). After surgery, patients in the PJK group had greater TLK (p < 0.001) and PJA (p < 0.001) compared with the non-PJK group. At final FU, patients in the PJK group had greater TK (p = 0.002), TLK (p < 0.001), SVA (p < 0.001), and PJA (p < 0.001) than patients in the non-PJK group (Table 4). In multivariate logistic regression analysis, higher VBQ score (OR 4.565, 95% CI 1.43–14.568, p = 0.010), advanced age (OR 1.119, 95% CI 1.021–1.227, p = 0.016), and larger TLK (OR 1.191, 95% CI 1.041–1.362, p = 0.011) were significant predictors of postoperative PJK in patients with DLS (Table 6). A statistically significant positive correlation existed between VBQ score and PJA change (r = 0.370, p < 0.001). We created ROC curves for VBQ scores as predictors of PJK with a diagnostic accuracy of 72.1% (95% CI 60.15–82.9%.The ideal limit for the VBQ score was 3.205 (sensitivity: 77.8%, specificity: 81.4%). Conclusion To the best of our knowledge, this is the first study to evaluate the effectiveness of the S1 VBQ score in predicting postoperative PJK in DLS. Our study included major risk factors and found that S1 VBQ score was a significant predictor of PJK in patients undergoing DLS surgery. The higher the S1 VBQ score, the higher the probability of PJK. |
| first_indexed | 2024-04-24T09:50:51Z |
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| language | English |
| last_indexed | 2024-04-24T09:50:51Z |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-30319310d0864bb2bc0481d5d7c375682024-04-14T11:23:02ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-04-011911810.1186/s13018-024-04722-ySimplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosisWei Deng0Yue Zhou1Qingsong Zhou2Yong Yin3Yueming Song4Ganjun Feng5Department of Orthopedics Surgery and Orthopedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Pidu District People’s Hospital/The Third Affiliated Hospital of Chengdu Medical CollegeDepartment of Orthopedics, Pidu District People’s Hospital/The Third Affiliated Hospital of Chengdu Medical CollegeDepartment of Orthopedics Surgery and Orthopedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics Surgery and Orthopedic Research Institute, West China Hospital, Sichuan UniversityAbstract Objective Our study aimed to assess the effectiveness of the simplified S1 vertebral bone quality (VBQ) score in predicting the incidence of proximal junctional kyphosis (PJK) after surgery for degenerative lumbar scoliosis (DLS). Methods We reviewed 122 patients with DLS who underwent posterior lumbar decompression and long-segment fusion surgery in our hospital from January 2016 to December 2020. The patients were classified into PJK group and non-PJK group. S1 VBQ scores are determined by signal intensity measurements taken from the mid-sagittal plane of T1-weighted non-contrast MRI. Logistic regression analysis was used to identify factors associated with PJK. Receiver-operating characteristic curve (ROC) analysis was used to evaluate the value of S1 VBQ score in predicting pedicle PJK after DLS. Results 122 DLS patients (90 females and 32 males) met the inclusion criteria. In addition, 27 patients (22.13%) had PJK at the time of last follow-up. VBQ was higher in PJK patients than non-PJK patients (3.58 ± 0.67 vs. 3.08 ± 0.54, p < 0.001). Preoperatively, patients in the PJK group had a greater TLK than those in the non-PJK group (20.00 ± 6.22 vs. 16.86 ± 5.38, p = 0.011). After surgery, patients in the PJK group had greater TLK (p < 0.001) and PJA (p < 0.001) compared with the non-PJK group. At final FU, patients in the PJK group had greater TK (p = 0.002), TLK (p < 0.001), SVA (p < 0.001), and PJA (p < 0.001) than patients in the non-PJK group (Table 4). In multivariate logistic regression analysis, higher VBQ score (OR 4.565, 95% CI 1.43–14.568, p = 0.010), advanced age (OR 1.119, 95% CI 1.021–1.227, p = 0.016), and larger TLK (OR 1.191, 95% CI 1.041–1.362, p = 0.011) were significant predictors of postoperative PJK in patients with DLS (Table 6). A statistically significant positive correlation existed between VBQ score and PJA change (r = 0.370, p < 0.001). We created ROC curves for VBQ scores as predictors of PJK with a diagnostic accuracy of 72.1% (95% CI 60.15–82.9%.The ideal limit for the VBQ score was 3.205 (sensitivity: 77.8%, specificity: 81.4%). Conclusion To the best of our knowledge, this is the first study to evaluate the effectiveness of the S1 VBQ score in predicting postoperative PJK in DLS. Our study included major risk factors and found that S1 VBQ score was a significant predictor of PJK in patients undergoing DLS surgery. The higher the S1 VBQ score, the higher the probability of PJK.https://doi.org/10.1186/s13018-024-04722-yProximal junctional kyphosisScoliosisVertebral bone qualityBone mineral density |
| spellingShingle | Wei Deng Yue Zhou Qingsong Zhou Yong Yin Yueming Song Ganjun Feng Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis Journal of Orthopaedic Surgery and Research Proximal junctional kyphosis Scoliosis Vertebral bone quality Bone mineral density |
| title | Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| title_full | Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| title_fullStr | Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| title_full_unstemmed | Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| title_short | Simplified S1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| title_sort | simplified s1 vertebral bone quality score independently predicts proximal junctional kyphosis after surgery for degenerative lumbar scoliosis |
| topic | Proximal junctional kyphosis Scoliosis Vertebral bone quality Bone mineral density |
| url | https://doi.org/10.1186/s13018-024-04722-y |
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