神戸大学附属図書館デジタルアーカイブ
https://hdl.handle.net/20.500.14094/90005958

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メタデータID
90005958
アクセス権
open access
出版タイプ
Version of Record
タイトル
Risk Factors for Proximal Junctional Fracture Following Fusion Surgery for Osteoporotic Vertebral Collapse with Delayed Neurological Deficits: A Retrospective Cohort Study of 403 Patients
著者
Tamai, Koji ; Terai, Hidetomi ; Suzuki, Akinobu ; Nakamura, Hiroaki ; Watanabe, Kei ; Katsumi, Keiichi ; Ohashi, Masayuki ; Shibuya, Yohei ; Izumi, Tomohiro ; Hirano, Toru ; Kaito, Takashi ; Yamashita, Tomoya ; Fujiwara, Hiroyasu ; Nagamoto, Yukitaka ; Matsuoka, Yuji ; Suzuki, Hidekazu ; Nishimura, Hirosuke ; Tagami, Atsushi ; Yamada, Syuta ; Adachi, Shinji ; Yoshii, Toshitaka ; Ushio, Shuta ; Harimaya, Katsumi ; Kawaguchi, Kenichi ; Yokoyama, Nobuhiko ; Oishi, Hidekazu ; Doi, Toshiro ; Kimura, Atsushi ; Inoue, Hirokazu ; Inoue, Gen ; Miyagi, Masayuki ; Saito, Wataru ; Nakano, Atsushi ; Sakai, Daisuke ; Nukaga, Tadashi ; Ikegami, Shota ; Shimizu, Masayuki ; Futatsugi, Toshimasa ; Ohtori, Seiji ; Furuya, Takeo ; Orita, Sumihisa ; Imagama, Shiro ; Ando, Kei ; Kobayashi, Kazuyoshi ; Kiyasu, Katsuhito ; Murakami, Hideki ; Yoshioka, Katsuhito ; Seki, Shoji ; Hongo, Michio ; Kakutani, Kenichiro ; Yurube, Takashi ; Aoki, Yasuchika ; Oshima, Masashi ; Takahata, Masahiko ; Iwata, Akira ; Endo, Hirooki ; Abe, Tetsuya ; Tsukanishi, Toshinori ; Nakanishi, Kazuyoshi ; Watanabe, Kota ; Hikata, Tomohiro ; Suzuki, Satoshi ; Isogai, Norihiro ; Okada, Eijiro ; Funao, Haruki ; Ueda, Seiji ; Shiono, Yuta ; Nojiri, Kenya ; Hosogane, Naobumi ; Ishii, Ken
著者名
Tamai, Koji
著者名
Terai, Hidetomi
著者名
Suzuki, Akinobu
著者名
Nakamura, Hiroaki
著者名
Watanabe, Kei
著者名
Katsumi, Keiichi
著者名
Ohashi, Masayuki
著者名
Shibuya, Yohei
著者名
Izumi, Tomohiro
著者名
Hirano, Toru
著者名
Kaito, Takashi
著者名
Yamashita, Tomoya
著者名
Fujiwara, Hiroyasu
著者名
Nagamoto, Yukitaka
著者名
Matsuoka, Yuji
著者名
Suzuki, Hidekazu
著者名
Nishimura, Hirosuke
著者名
Tagami, Atsushi
著者名
Yamada, Syuta
著者名
Adachi, Shinji
著者名
Yoshii, Toshitaka
著者名
Ushio, Shuta
著者名
Harimaya, Katsumi
著者名
Kawaguchi, Kenichi
著者名
Yokoyama, Nobuhiko
著者名
Oishi, Hidekazu
著者名
Doi, Toshiro
著者名
Kimura, Atsushi
著者名
Inoue, Hirokazu
著者名
Inoue, Gen
著者名
Miyagi, Masayuki
著者名
Saito, Wataru
著者名
Nakano, Atsushi
著者名
Sakai, Daisuke
著者名
Nukaga, Tadashi
著者名
Ikegami, Shota
著者名
Shimizu, Masayuki
著者名
Futatsugi, Toshimasa
著者名
Ohtori, Seiji
著者名
Furuya, Takeo
著者名
Orita, Sumihisa
著者名
Imagama, Shiro
著者名
Ando, Kei
著者名
Kobayashi, Kazuyoshi
著者名
Kiyasu, Katsuhito
著者名
Murakami, Hideki
著者名
Yoshioka, Katsuhito
著者名
Seki, Shoji
著者名
Hongo, Michio
著者ID
A1461
研究者ID
1000010533739
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=3401110282b6c620520e17560c007669
著者名
Kakutani, Kenichiro
角谷, 賢一朗
カクタニ, ケンイチロウ
所属機関名
医学研究科
著者ID
A2131
研究者ID
1000010514648
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=564b5b743f5a7d84520e17560c007669
著者名
Yurube, Takashi
由留部, 崇
ユルベ, タカシ
所属機関名
医学部附属病院
著者名
Aoki, Yasuchika
著者名
Oshima, Masashi
著者名
Takahata, Masahiko
著者名
Iwata, Akira
著者名
Endo, Hirooki
著者名
Abe, Tetsuya
著者名
Tsukanishi, Toshinori
著者名
Nakanishi, Kazuyoshi
著者名
Watanabe, Kota
著者名
Hikata, Tomohiro
著者名
Suzuki, Satoshi
著者名
Isogai, Norihiro
著者名
Okada, Eijiro
著者名
Funao, Haruki
著者名
Ueda, Seiji
著者名
Shiono, Yuta
著者名
Nojiri, Kenya
著者名
Hosogane, Naobumi
著者名
Ishii, Ken
収録物名
Spine Surgery and Related Research
巻(号)
3(2)
ページ
171-177
出版者
The Japanese Society for Spine Surgery and Related Research
刊行日
2019
公開日
2019-05-17
抄録
Introduction: Approximately 3% of osteoporotic vertebral fractures develop osteoporotic vertebral collapse (OVC) with neurological deficits, and such patients are recommended to be treated surgically. However, a proximal junctional fracture (PJFr) following surgery for OVC can be a serious concern. Therefore, the aim of this study is to identify the incidence and risk factors of PJFr following fusion surgery for OVC. Methods: This study retrospectively analyzed registry data collected from facilities belonging to the Japan Association of Spine Surgeons with Ambition (JASA) in 2016. We retrospectively analyzed 403 patients who suffered neurological deficits due to OVC below T10 and underwent corrective surgery; only those followed up for ≥2 years were included. Potential risk factors related to the PJFr and their cut-off values were calculated using multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis. Results: Sixty-three patients (15.6%) suffered PJFr during the follow-up (mean 45.7 months). In multivariate analysis, the grade of osteoporosis (grade 2, 3: adjusted odds ratio (aOR) 2.92; p=0.001) and lower instrumented vertebra (LIV) level (sacrum: aOR 6.75; p=0.003) were independent factors. ROC analysis demonstrated that lumbar bone mineral density (BMD) was a predictive factor (area under curve: 0.72, p=0.035) with optimal cut-off value of 0.61 g/cm(2) (sensitivity, 76.5%; specificity, 58.3%), but that of the hip was not (p=0.228). Conclusions: PJFr was found in 16% cases within 4 years after surgery; independent risk factors were severe osteoporosis and extended fusion to the sacrum. The lumbar BMD with cut-off value 0.61 g/cm(2) may potentially predict PJFr. Our findings can help surgeons select perioperative adjuvant therapy, as well as a surgical strategy to prevent PJFr following surgery.
キーワード
Osteoporosis
vertebral fracture
proximal junctional fracture
corrective surgery
proximal junctional kyphosis
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
権利
©2019 The Japanese Society for Spine Surgery and Related Research.
CC license
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).