Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis
IntroductionDistal junctional kyphosis (DJK) is a serious complication after posterior spinal surgery in managing adolescent idiopathic scoliosis (AIS). Our study aims to investigate the predictors of DJK in AIS patients.MethodsWe searched the English databases of PubMed, Embase, and the Cochrane Li...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1263655/full |
| _version_ | 1797657322372202496 |
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| author | Ruili Jia Yubin Long |
| author_facet | Ruili Jia Yubin Long |
| author_sort | Ruili Jia |
| collection | DOAJ |
| description | IntroductionDistal junctional kyphosis (DJK) is a serious complication after posterior spinal surgery in managing adolescent idiopathic scoliosis (AIS). Our study aims to investigate the predictors of DJK in AIS patients.MethodsWe searched the English databases of PubMed, Embase, and the Cochrane Library for clinical research studies on AIS. To identify the risk factors for DJK, we collected demographic data, such as age, gender, and body mass index (BMI), and sagittal parameters, including preoperative pelvic tilt (PT), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), distal junctional angle (DJA), lowest instrumented vertebrae (LIV) relative to sagittal stable vertebrae (SSV), and postoperative DJA. Data were analyzed by RevMan (5.3 version) and STATA (12.0 version).ResultsFinally, six included articles (1,240 patients) showed 9% (98 of 1,240 patients) of patients suffering from DJK. Our findings indicated that preoperative TK [p = 0.007, OR = 0.35, 95% CI (0.10, 0.61)], TLK [p < 0.0001, OR = 5.99, 95% CI (3.33, 8.65)], and postoperative DJA [p = 0.002, OR = 0.56, 95% CI (0.21, 0.91)] in the DJK group were markedly higher than those in the non-DJK group. Moreover, patients with LIV above SSV [p < 0.0001, OR = 7.95, 95% CI (4.16, 15.22)] were more likely to develop DJK. No discernible difference was found in age, sex, BMI, preoperative PT, SVA, LL, or DJA between the two groups.ConclusionsRegarding the AIS patients, factors such as higher preoperative TK and TLK, higher postoperative DJA, and LIV above the SSV were related to an increased rate of DJK. |
| first_indexed | 2024-03-11T17:43:48Z |
| format | Article |
| id | doaj.art-5c006e736d324fbd8a4de87f188c63d8 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-11T17:43:48Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-5c006e736d324fbd8a4de87f188c63d82023-10-18T08:40:45ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-10-011010.3389/fsurg.2023.12636551263655Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysisRuili Jia0Yubin Long1Department of Nephrology, The First Central Hospital of Baoding, Baoding, ChinaDepartment of Orthopedics, The First Central Hospital of Baoding, Baoding, ChinaIntroductionDistal junctional kyphosis (DJK) is a serious complication after posterior spinal surgery in managing adolescent idiopathic scoliosis (AIS). Our study aims to investigate the predictors of DJK in AIS patients.MethodsWe searched the English databases of PubMed, Embase, and the Cochrane Library for clinical research studies on AIS. To identify the risk factors for DJK, we collected demographic data, such as age, gender, and body mass index (BMI), and sagittal parameters, including preoperative pelvic tilt (PT), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), distal junctional angle (DJA), lowest instrumented vertebrae (LIV) relative to sagittal stable vertebrae (SSV), and postoperative DJA. Data were analyzed by RevMan (5.3 version) and STATA (12.0 version).ResultsFinally, six included articles (1,240 patients) showed 9% (98 of 1,240 patients) of patients suffering from DJK. Our findings indicated that preoperative TK [p = 0.007, OR = 0.35, 95% CI (0.10, 0.61)], TLK [p < 0.0001, OR = 5.99, 95% CI (3.33, 8.65)], and postoperative DJA [p = 0.002, OR = 0.56, 95% CI (0.21, 0.91)] in the DJK group were markedly higher than those in the non-DJK group. Moreover, patients with LIV above SSV [p < 0.0001, OR = 7.95, 95% CI (4.16, 15.22)] were more likely to develop DJK. No discernible difference was found in age, sex, BMI, preoperative PT, SVA, LL, or DJA between the two groups.ConclusionsRegarding the AIS patients, factors such as higher preoperative TK and TLK, higher postoperative DJA, and LIV above the SSV were related to an increased rate of DJK.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1263655/fullrisk factorsdistal junctional kyphosisposterior spinal surgeryadolescent idiopathic scoliosismeta-analysis |
| spellingShingle | Ruili Jia Yubin Long Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis Frontiers in Surgery risk factors distal junctional kyphosis posterior spinal surgery adolescent idiopathic scoliosis meta-analysis |
| title | Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis |
| title_full | Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis |
| title_fullStr | Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis |
| title_full_unstemmed | Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis |
| title_short | Risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis: a meta-analysis |
| title_sort | risk factors for distal junctional kyphosis after posterior spinal surgery in adolescent idiopathic scoliosis a meta analysis |
| topic | risk factors distal junctional kyphosis posterior spinal surgery adolescent idiopathic scoliosis meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1263655/full |
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