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Segi N, Nakashima H, Kanemura T, Satake K, Ito K, Tsushima M, Tanaka S, Ando K, Machino M, Ito S, Yamaguchi H, Koshimizu H, Tomita H, Ouchida J, Morita Y, Imagama S. Comparison of Outcomes between Minimally Invasive Lateral Approach Vertebral Reconstruction Using a Rectangular Footplate Cage and Conventional Procedure Using a Cylindrical Footplate Cage for Osteoporotic Vertebral Fracture. J Clin Med 2021; 10:5664. [PMID: 34884365 PMCID: PMC8658075 DOI: 10.3390/jcm10235664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of the current study was to compare outcomes between lateral access vertebral reconstruction (LAVR) using a rectangular footplate cage and the conventional procedure using a cylindrical footplate cage in patients with osteoporotic vertebral fracture (OVF). We included 46 patients who underwent anterior-posterior combined surgery for OVF: 24 patients underwent LAVR (Group L) and 22 underwent the conventional procedure (Group C). Preoperative, postoperative, and 1- and 2-year follow-up X-ray images were used to measure local lordotic angle, correction loss, and cage subsidence (>2 mm in vertebral endplate depression). In anterior surgery, the operation time was significantly shorter (183 vs. 248 min, p < 0.001) and the blood loss was significantly less (148 vs. 406 mL, p = 0.01) in Group L than in Group C. In Group C, two patients had anterior instrumentation failure. Correction loss was significantly smaller in Group L than in Group C (1.9° vs. 4.9° at 1 year, p = 0.02; 2.5° vs. 6.5° at 2 years, p = 0.04, respectively). Cage subsidence was significantly less in Group L than in Group C (29% vs. 80%, p < 0.001). LAVR using a rectangular footplate cage is an effective treatment for OVF to minimize surgical invasiveness and postoperative correction loss.
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Affiliation(s)
- Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Tokumi Kanemura
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Kotaro Satake
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Kenyu Ito
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Mikito Tsushima
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Satoshi Tanaka
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Kei Ando
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Hidetoshi Yamaguchi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Hiroyuki Koshimizu
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Hiroyuki Tomita
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Jun Ouchida
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
- Department of Orthopedic Surgery, Konan Kosei Hospital, 137 Takayamachi Omatsubara, Konan 483-8704, Japan; (T.K.); (K.S.); (K.I.); (M.T.); (S.T.)
| | - Yoshinori Morita
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (N.S.); (K.A.); (M.M.); (S.I.); (H.Y.); (H.K.); (H.T.); (J.O.); (Y.M.); (S.I.)
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Eryilmaz F, Ahmed F, Rehmani AK, Karimi S, Qazi A, Mustafa S, Zulfiqar A, Nadeem Z, Sultan AA, Farooque U. Scoliosis and Gastroesophageal Reflux Disease in Adults. Cureus 2021; 13:e15359. [PMID: 34239791 PMCID: PMC8245622 DOI: 10.7759/cureus.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction Degenerative scoliosis most commonly presents with lower back pain. Literature suggests that adults who have degenerative scoliosis are at greater risk of both hiatal hernia and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate scoliosis as being the risk factor of GERD in adults. Materials and methods This prospective study was conducted at Dow University of Health Sciences over a period of two years (May 2018 to April 2020). The investigation included 210 participants with spinal disorders. The mean age was 71.6±9.6 years. The X-rays of the participants’ whole spine were taken in a standing position, in the sagittal and coronal planes. Symptoms of GERD were measured through the quality of life and utility evaluation survey technology (QUEST) score, taking six points as cutoff values. The evaluation was done using radiographs to determine any relationship between spinal disorders and GERD. Negative values were analyzed in a right-sided convex curve while positive values in the left-sided convex curve were viewed in the coronal plane. Degenerative scoliosis was explained as a lumbar/thoracolumbar Cobb angle of more than 10 degrees. Univariate and multivariate logistic regression analyses were done to assess the risk factors related to GERD. Results Out of 210 patients, 146 were found to have degenerative scoliosis at the level of the lumbar and thoracolumbar spine. Fifty-two patients had a right convex curve, and 94 had a left convex curve. Sixty-nine patients had GERD. According to the analysis of the multivariate logistic regression, the Cobb angle was highly related to GERD (p-value <0.05 and odds ratio of 1.031). The participants were grouped according to the Cobb angle of curve at the lumbar spine (less than 30 degrees with a large right-sided convex curve, 30 and more with a small curve, and more than 30+ degrees with a large left-sided convex curve). The study revealed that a large left-sided convex curve was highly related to GERD, with a p-value <0.05 and odds ratio of 10.935. Conclusions The left-sided large convex curve at the thoracolumbar or lumbar spine, especially when the Cobb angle was more than 30 degrees, was highly associated with GERD. Therefore, the symptoms of GERD should be monitored in the elderly population with degenerative scoliosis.
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Affiliation(s)
- Fahri Eryilmaz
- Neurological Surgery, Hitit University Corum Erol Olcok Training and Research Hospital, Corum, TUR
| | - Faheem Ahmed
- Orthopedic Surgery, Trauma Centre, Civil Hospital, Karachi, PAK
| | - Asim K Rehmani
- Neurological Surgery, National Medical Center, Karachi, PAK
| | - Sundas Karimi
- Orthopedic Surgery, Dow University Hospital, Karachi, PAK
| | - Aamna Qazi
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Sufyan Mustafa
- Medicine, Dow Medical College, Civil Hospital, Karachi, PAK
| | - Arif Zulfiqar
- Medicine and Surgery, Dow Medical College, Karachi, PAK
| | - Zubia Nadeem
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ayyaz A Sultan
- Hematology/Oncology, California Cancer Associates for Research and Excellence, Fresno, USA
| | - Umar Farooque
- Neurology, Dow University of Health Sciences, Karachi, PAK
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