• World Neurosurg · Jun 2017

    Meta Analysis

    Upper Thoracic Versus lower Thoracic as Site of Upper-instrumented Vertebrae for Long Fusion Surgery in Adult Spinal Deformity: A Meta-analysis of Proximal Junctional Kyphosis.

    • Ming Luo, Pu Wang, Wengang Wang, Mingkui Shen, Genzhong Xu, and Lei Xia.
    • Department of Orthopaedic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
    • World Neurosurg. 2017 Jun 1; 102: 200-208.

    ObjectiveA meta-analysis was performed to compare incidence rates of radiographic and surgical proximal junctional kyphosis (PJK) between upper thoracic (UT) and lower thoracic (LT) vertebrae as site of upper instrumented vertebrae (UIV) endpoints for long fusion surgery in adult spinal deformity (ASD).MethodsMEDLINE, Embase, and Cochrane Library databases were searched for English-language articles that addressed UT versus LT fixation strategies. The division of the UT and LT groups was based on UIV. Two reviewers independently assessed the quality of the studies using the Newcastle-Ottawa Scale. Data on incidence rates of radiographic and surgical PJK were extracted from the included studies. RevMan 5.3 was used for data pooling and analysis.ResultsTen retrospective studies comprising 1230 patients were included. Pooled data on radiographic PJK were available in 9 studies comprising 1032 patients, and total radiographic PJK rate was 32.2%. Pooled data on surgical PJK were available in 6 studies comprising 732 patients, and total surgical PJK rate was 6.7%. Decreased radiographic PJK (95% confidence interval, 0.49-0.85; P = 0.002; I2 = 48%) and surgical PJK (95% confidence interval, 0.18-0.76; P = 0.007; I2 = 22%) were found in the UT group.ConclusionsRadiographic PJK is a very common complication of long fusion surgery in adult spinal deformity with an incidence rate of 32.2%. Surgical PJK has an incidence rate of 6.7% and should be seriously considered. The pooled results indicate that choosing UT vertebrae as the site of UIV could decrease the incidence rates of radiographic and surgical PJK.Copyright © 2017 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…