Correction of post-traumatic hyperkyphosis of the upper thoracic spine by multiple Chevron osteotomies.
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ABSTRACT:
SUBMITTER: Kandziora F
PROVIDER: S-EPMC7571855 | biostudies-literature | 2010 Dec
REPOSITORIES: biostudies-literature
Publications
Correction of post-traumatic hyperkyphosis of the upper thoracic spine by multiple Chevron osteotomies.
Kandziora Frank F Schnake Klaus J KJ
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 20101201 12
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Project description:Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was the development of distal junctional kyphosis (DJK). Summary of Background Data Prior research has pointed to selection of the FLV for the distal instrumentation level in fusion for thoracic hyperkyphosis. In 2009, Cho et al introduced the concept of the SSV after recognizing the development of DJK despite fusion to the FLV. Methods Patients were reviewed who had undergone spinal fusion for thoracic hyperkyphosis. Preoperative radiographs were reviewed to assess thoracic kyphosis, lumbar lordosis, SSV, and FLV. Postoperative radiographs were reviewed to assess curve correction and whether patients developed DJK or implant failure. Results We reviewed 22 patients with a mean age at surgery of 18 (range 14 to 22). Mean preoperative kyphosis was 85 ± 14 degrees, and mean postoperative kyphosis at final follow-up was 59 ± 12 degrees for a mean correction of 26 ± 12 degrees. Eleven patients developed DJK and four patients experienced hardware failure. In 12 patients, the SSV was inferior to the FLV. Rates of DJK when the instrumentation included the SSV or FLV were 13 and 38%, respectively. Conclusions Fusion to the SSV is superior at preventing DJK when compared with fusion to the FLV.
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Project description:IntroductionUpper quadrant musculoskeletal disorders (UQMD), comprising of cranial, cervical, shoulder and upper extremity disorders, are among the most frequently reported disorders in clinical practice. Thoracic high velocity low amplitude thrust (Tx-HVLAT) manipulation is a form of conservative management recommended in systematic reviews as an effective treatment option for aspects of UQMD disorders such headache, shoulder pain and lateral elbow pain. However, no recent systematic reviews have assessed the effectiveness across UQMD. Therefore, this systematic review aims to update the current evidence on the effectiveness of Tx-HVLAT for patients with UQMD on (1) patient-reported outcomes, (2) performance measures or (3) psychosocial outcomes.Methods and analysisThe Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PEDro and Index to Chiropractic Literature will be searched from inception using Medical Subject Headings (MeSH), Thesaurus and/or free-text words. Combinations will be made based on localisation, disorder, intervention and design. Following guidelines as advised by the Cochrane Back Review Group, published randomised controlled trials will be included. Two review authors will independently assess the risk of bias (ROB) using the Cochrane Back Review Group's recommended ROB2 tool and will independently extract the data using a standardised data extraction form. Overall quality of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. For continuous data, we will calculate standardised mean differences with 95% CIs. For dichotomous outcomes, relative risks and 95% CIs will be calculated. Where possible we will present a subgroup analysis by disorder. For pooling, a random-effects model will be used.Ethics and disseminationEthics approval is not required for this systematic review. The study findings will be submitted to a relevant peer-reviewed journal for dissemination and presented at relevant conferences.Prospero registration numberCRD42023429996.
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