PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics
Version 1
: Received: 9 April 2024 / Approved: 9 April 2024 / Online: 10 April 2024 (13:13:00 CEST)
How to cite:
Onafowokan, O.O.; Imbo, B.; Williamson, T.; Das, A.; Mir, J.M.; Galetta, M.; Lorentz, N.; Passias, P.G. Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics. Preprints2024, 2024040698. https://doi.org/10.20944/preprints202404.0698.v1
Onafowokan, O.O.; Imbo, B.; Williamson, T.; Das, A.; Mir, J.M.; Galetta, M.; Lorentz, N.; Passias, P.G. Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics. Preprints 2024, 2024040698. https://doi.org/10.20944/preprints202404.0698.v1
Onafowokan, O.O.; Imbo, B.; Williamson, T.; Das, A.; Mir, J.M.; Galetta, M.; Lorentz, N.; Passias, P.G. Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics. Preprints2024, 2024040698. https://doi.org/10.20944/preprints202404.0698.v1
APA Style
Onafowokan, O.O., Imbo, B., Williamson, T., Das, A., Mir, J.M., Galetta, M., Lorentz, N., & Passias, P.G. (2024). Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics. Preprints. https://doi.org/10.20944/preprints202404.0698.v1
Chicago/Turabian Style
Onafowokan, O.O., Nathan Lorentz and Peter G Passias. 2024 "Is it Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to their Unaffected Counterparts: an Analysis of Recovery Kinetics" Preprints. https://doi.org/10.20944/preprints202404.0698.v1
Abstract
BACKGROUND: Distal junctional kyphosis (DJK) remains a primary concern for surgeons performing cervical deformity (CD) surgery. Many times post-operative complications from CD surgeries render patients with worse recovery profiles than their peers. It is important to understand DJK recovery profiles following CD surgery patients.
PURPOSE: To identify if DJK patients successfully recover from treatment/reoperation
STUDY DESIGN/SETTING: Retrospective review of prospectively collected database
PATIENT SAMPLE: 113 CD patients
OUTCOME MEASURES: CD, HRQL, DJK, Recovery kinetics
METHODS: CD patients with available BL and 2Y follow-up data. DJK angle (DJKA) was defined as >10° change in kyphosis between LIV and LIV-2, and a >10° index angle. Patients were stratified into two groups: 1) those who developed DJK by 3M and 2) those that did not develop DJK. Patients who developed DJK beyond 3M were excluded from the study. Means comparison tests analyzed differences in demographic, surgical, radiographic, and health related quality of life (HRQL) scores. Normalized HRQL scores at 3M and follow-up intervals (6M, 1Y, 2Y) were generated. Regression analysis assessed patient reported outcomes adjusting for baseline and surgical characteristics.
RESULTS: 113 patients were included (17 DJK, 96 no DJK). Age (60.3 vs 62.2), gender (F: 71.0% vs 61.0%), BMI (27.0 vs 28.3), CCI (0.77 vs 0.98), OpTime (484.0 vs 556.5min), EBL (1028.3 vs 843.9mL), and presenting neurologic symptoms (70.6% vs 76.0%) were similar between groups (P > .05). DJK patients were more sagittally-malaligned preop (cervical sagittal vertical axis {cSVA}: 59.0 vs 43.9); had more osteotomies (76.5% vs 49.0%), and underwent more combined approaches (64.7% vs 26.0%), all p < .05. Posterior approaches, decompressions, and levels fused were similar between groups (p > .05). Following surgery, rate of complications and neurologic symptoms were similar between groups, except DJK patients experienced more dysphagia (17.7% vs 4.2%; p=0.034). DJK patients remained more malaligned in cSVA through 2-yr follow-up (p < .05). DJK patients exhibited worse reported outcomes from 3M to 1Y (p < .05), but these differences subsided when following patients through to 2Y: worse NDI (65.3 vs 35.3) and EQ5D (0.68 vs 0.79) scores at 1Y (both P
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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