Prevalent morphometric vertebral fractures as a risk factor for subsequent clinical vertebral fractures after shortfusion surgery in older Japanese women with degenerative spondylolisthesis.

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-06-01 Epub Date: 2024-06-25 DOI:10.31616/asj.2023.0327
Yosuke Oishi, Eiichiro Nakamura, Keiji Muramatsu, Masaaki Murase, Katsumi Doi, Yoshinori Takeuchi, Jun-Ichi Hamawaki, Akinori Sakai
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Abstract

Study design: A retrospective cohort study using the Kaplan-Meier method with propensity-score matching.

Purpose: To evaluate whether the presence of prevalent morphometric vertebral fractures (VFs) poses a risk for subsequent clinical VFs after short-fusion surgery in women aged ≥60 years with degenerative spondylolisthesis.

Overview of literature: VFs are common osteoporotic fractures and are associated with a low quality of life. Subsequent VFs are a complication of instrumented fusion in patients with degenerative lumbar disorders. Thus, risk factors for subsequent VFs after fusion surgery must be analyzed. Population-based studies have suggested that prevalent morphometric VFs led to a higher incidence of subsequent VFs in postmenopausal women; however, no studies have investigated whether prevalent morphometric VFs are a risk factor for subsequent VFs after fusion surgery in patients with degenerative spondylolisthesis.

Methods: The study enrolled a total of 237 older female patients: 50 and 187 patients had prevalent morphometric VFs (VF [+] group) and nonprevalent morphometric VFs (VF [-] group), respectively. The time to subsequent clinical VFs after fusion surgery was compared between the two groups using the Kaplan-Meier method. Moreover, 40 and 80 patients in the VF (+) and VF (-) groups, respectively, were analyzed and matched by propensity scores for age, follow-up duration, surgical procedure, number of fused segments, body mass index, and number of patients treated for osteoporosis.

Results: Kaplan-Meier analysis indicated that the VF (+) group had a higher incidence of subsequent clinical VFs than the VF (-) group, and Cox regression analysis showed that the presence of prevalent morphometric VFs was an independent risk factor for subsequent clinical VFs before matching. Kaplan-Meier analysis demonstrated comparable results after matching.

Conclusions: The presence of prevalent morphometric VFs may be a risk factor for subsequent clinical VFs in older women with degenerative spondylolisthesis who underwent short-fusion surgery.

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日本老年女性退行性脊椎滑脱症患者在短融合手术后发生临床脊椎骨折的风险因素--脊椎骨折的形态测量。
研究设计目的:评估在年龄≥60 岁的退行性脊椎滑脱症女性患者中,普遍存在的形态学椎体骨折(VFs)是否构成短融合手术后发生临床 VFs 的风险:VF是常见的骨质疏松性骨折,与生活质量低下有关。继发性 VF 是退行性腰椎疾病患者器械融合术的并发症之一。因此,必须对融合手术后继发性室间隔缺损的风险因素进行分析。基于人群的研究表明,在绝经后妇女中,普遍存在的形态学 VF 会导致较高的后续 VF 发生率;然而,目前还没有研究调查普遍存在的形态学 VF 是否是退行性脊椎滑脱症患者在融合手术后发生后续 VF 的风险因素:该研究共招募了 237 名老年女性患者:分别有50名和187名患者患有流行性形态学VF(VF[+]组)和非流行性形态学VF(VF[-]组)。两组患者在融合手术后出现临床室颤的时间采用 Kaplan-Meier 法进行比较。此外,还对 VF (+) 组和 VF (-) 组的 40 名和 80 名患者进行了分析,并根据年龄、随访时间、手术方法、融合节段数、体重指数和接受过骨质疏松症治疗的患者人数进行了倾向评分匹配:Kaplan-Meier分析表明,VF(+)组患者后续临床VF的发生率高于VF(-)组,而Cox回归分析表明,在匹配前,存在流行的形态学VF是后续临床VF的独立风险因素。Kaplan-Meier分析显示,匹配后的结果与之相当:结论:在接受短融合手术的退行性脊椎滑脱症老年妇女中,普遍存在的形态学 VFs 可能是后续临床 VFs 的风险因素。
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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
期刊最新文献
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