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Journals / Acta Orthopaedica et Traumatologica Turcica / 2018 / Cilt: 52 - Sayı: 1

Selection of distal fusion level in terms of distal junctional kyphosis in Scheuermann kyphosis. A comparison of 3 methods

FATİH DİKİCİ
Turgut AKGULB
Kerim SARIYILMAZ
Murat KORKMAZC
Okan OZKUNTA
Cuneyt SARB
Ünsal DOMANİÇ
Pages
7–11
DOI
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This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Objective & Hypothesis:Objective: The aim of this study was to investigate the effect of distal fusion level selection on the distaljunctional kyphosis (DJK) in Scheuermann kyphosis (SK) patients who underwent posterior fusion.Methods: Thirty-nine SK patients who underwent posterior fusion with a minimum follow-up of 3 yearswere retrospectively evaluated.
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Key Findings & Data:According to the distal fusion level, patients were divided into 3 groups.Group S; lowest instrumented vertebra (LIV) was the sagittal stable vertebra (SSV), Group F; LIV was theŞrst lordotic vertebra (FLV) and, Group L; LIV was the lower end vertebra (LEV).
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Conclusion & Impact:This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
🔬Design:Research Article
📍Scope:2017 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: The aim of this study was to investigate the effect of distal fusion level selection on the distaljunctional kyphosis (DJK) in Scheuermann kyphosis (SK) patients who underwent posterior fusion.Methods: Thirty-nine SK patients who underwent posterior fusion with a minimum follow-up of 3 yearswere retrospectively evaluated. According to the distal fusion level, patients were divided into 3 groups.Group S; lowest instrumented vertebra (LIV) was the sagittal stable vertebra (SSV), Group F; LIV was theŞrst lordotic vertebra (FLV) and, Group L; LIV was the lower end vertebra (LEV). DJK was evaluated according to distal level selection.Results: Thoracic kyphosis (TK) decreased from 73.3(SD± 7.9) to 39(SD± 8.7) postoperatively, witha mean correction rate of 46% (SD± 13) (p < 0.0001). In 11 patients, FLV and SSV was the same vertebra.In remaining 28 patients, 10 patients were in Group S, 15 patients were in Group F and 3 patients were inGroup L. In Group S, none of them developed DJK, however, DJK was observed 9 of 15 patients in Group F.DJK was developed in all cases in Group L. There is a statistically higher risk for developing DJK when FLVor LEV was selected as LIV (p< 0.05).Conclusion: Selecting SSV for the distal fusion level has been found to be effective for preventing DJK.Selecting distal fusion level proximal to SSV will increase the risk of DJK which may become symptomaticand require revision surgery.Level of evidence: Level IV, therapeutic study.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Cite This Article

DİKİCİ, F., AKGULB, T., SARIYILMAZ, K., KORKMAZC, M., OZKUNTA, O., SARB, C., DOMANİÇ, Ü. (2018). Selection of distal fusion level in terms of distal junctional kyphosis in Scheuermann kyphosis. A comparison of 3 methods. Acta Orthopaedica et Traumatologica Turcica, Cilt: 52 - Sayı: 1, 7–11. https://ajindex.com/articles/160504

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