Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study
Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5871 |
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| author | Tomoyuki Asada Kousei Miura Masao Koda Hideki Kadone Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Yosuke Shibao Kosuke Sato Fumihiko Eto Kentaro Mataki Masashi Yamazaki |
| author_facet | Tomoyuki Asada Kousei Miura Masao Koda Hideki Kadone Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Yosuke Shibao Kosuke Sato Fumihiko Eto Kentaro Mataki Masashi Yamazaki |
| author_sort | Tomoyuki Asada |
| collection | DOAJ |
| description | Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK. Methods: We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (−). Results: PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (−) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, <i>p</i> = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK. Conclusions: Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD. |
| first_indexed | 2024-03-09T21:33:43Z |
| format | Article |
| id | doaj.art-d06287ee574a4651820db5e8ba5c1b8f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:33:43Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d06287ee574a4651820db5e8ba5c1b8f2023-11-23T20:50:13ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011119587110.3390/jcm11195871Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control StudyTomoyuki Asada0Kousei Miura1Masao Koda2Hideki Kadone3Toru Funayama4Hiroshi Takahashi5Hiroshi Noguchi6Yosuke Shibao7Kosuke Sato8Fumihiko Eto9Kentaro Mataki10Masashi Yamazaki11Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanCenter for Innovative Medicine and Engineering, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanDepartment of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami 300-0395, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, JapanBackground: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK. Methods: We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (−). Results: PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (−) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, <i>p</i> = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK. Conclusions: Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD.https://www.mdpi.com/2077-0383/11/19/5871PJK3D gait analysisadult spinal deformitydegenerative lumbar kyphoscoliosisspinal sagittal alignmentdynamic spinal alignment |
| spellingShingle | Tomoyuki Asada Kousei Miura Masao Koda Hideki Kadone Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Yosuke Shibao Kosuke Sato Fumihiko Eto Kentaro Mataki Masashi Yamazaki Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study Journal of Clinical Medicine PJK 3D gait analysis adult spinal deformity degenerative lumbar kyphoscoliosis spinal sagittal alignment dynamic spinal alignment |
| title | Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study |
| title_full | Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study |
| title_fullStr | Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study |
| title_full_unstemmed | Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study |
| title_short | Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study |
| title_sort | can proximal junctional kyphosis after surgery for adult spinal deformity be predicted by preoperative dynamic sagittal alignment change with 3d gait analysis a case control study |
| topic | PJK 3D gait analysis adult spinal deformity degenerative lumbar kyphoscoliosis spinal sagittal alignment dynamic spinal alignment |
| url | https://www.mdpi.com/2077-0383/11/19/5871 |
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