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Sagittal Balance In Hyperkyphotic Patients With Growing Rods and the Effect of Preoperative Sagittal Balance In Hyperkyphotic Patients With Growing Rods and the Effect of Preoperative

Sagittal Balance In Hyperkyphotic Patients With Growing Rods and the Effect of Preoperative - PowerPoint Presentation

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Uploaded On 2020-08-06

Sagittal Balance In Hyperkyphotic Patients With Growing Rods and the Effect of Preoperative - PPT Presentation

Cynthia V Nguyen MD 2 Henry Ofori Duah RN MPH 1 Mabel Owiredu 1 Henry Osei Tutu BS 1 Kwadwo Poku Yankey MD 1 Irene Wulff MD 1 Henry Akoto MB ChB 1 Oheneba Boachie ID: 800848

kyphosis pjk patients growing pjk kyphosis growing patients rods preoperative hgt pelvic risk hyperkyphotic high pjkearly results conclusions factors

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Slide1

Sagittal Balance In Hyperkyphotic Patients With Growing Rods and the Effect of Preoperative Halo Gravity Traction

Cynthia V. Nguyen, MD2Henry Ofori Duah, RN MPH1Mabel Owiredu1Henry Osei Tutu, BS1Kwadwo Poku Yankey, MD1Irene Wulff, MD1Henry Akoto, MB ChB1Oheneba Boachie-Adjei, MD1FOCOS Spine Research Group

2

1

Slide2

Background

Proximal junctional kyphosis (PJK) is a prevalent complication of growing rod treatment for EOSPreviously identified risk factors:HyperkyphosisAbnormal pelvic incidence (PI)2

Slide3

Background

In population of patients who all have hyperkyphosis, what are the risks of PJK?Would halo gravity traction (HGT) have a protective effect on the risks of PJK?3

Slide4

Materials and Methods

Retrospective review, single centerInclusion criteria:EOS treated with growing rodsPreoperative kyphosis > 40 degrees≥ 2 years of followup4

Slide5

Materials and Methods

Clinical data collectionDemographicsSurgical detailsClinical courseRadiographic data collectionX-rays were taken at regular follow-up visitsSagittal parameters measured5

Slide6

Results

49 patients met inclusion criteriaAverage age at surgery: 7.5 yrs (range 2-14)39% underwent preop HGTAverage duration 9.3 wks(range 4-20)35% rate of PJK81% of PJK was identified within 1 year of surgery 6

Slide7

Results

7Variable

Non-PJK group (n=49)

PJK group (n= 19)

p-value

Preoperative kyphosis

71.0 ± 16.1°

84.4 ± 14.0°

0.008

Postoperative kyphosis

48.9 ± 18.1°

53.5 ± 19.5°

0.42

Postoperative pelvic incidence

39.8 ± 10.5°

49.3 ± 14.0°

0.02

Age

7.4 ± 2.8

7.8 ± 2.2

0.63

Number of levels included

14.6 ± 0.9

14.5 ± 1.2

0.63

Kyphosis correction index

0.7 ± 0.2

0.6 ± 0.2

0.09

Slide8

Results

8Variable

No HGT (n=30)

HGT (n= 19)

p-value

Kyphosis at presentation

72.5 ± 16.8°

106.5 ± 11.7°

0.00

Preoperative kyphosis

72.5 ± 16.8°

81.2 ± 15.2°

0.09

Postoperative kyphosis

41.7 ± 14.3°

64.0 ± 16.3°

0.00

Rate of PJK

8/30 (27%)

9/19 (47%)

0.14

Slide9

Conclusions

Hyperkyphotic patients with growing rods have high risk of PJKEarly identification9

Slide10

Conclusions

Hyperkyphotic patients with growing rods have high risk of PJKEarly identificationSignificant factors for PJK in growing rods:Amount of preoperative kyphosisAmount of pelvic incidence10

Slide11

Conclusions

Hyperkyphotic patients with growing rods have high risk of PJKEarly identificationSignificant factors for PJK in growing rods:Amount of preoperative kyphosisAmount of pelvic incidenceDespite starting out with more kyphosis, HGT patients did not have more PJKSuggests that HGT has a protective effect against PJK11

Slide12

Thank You!12