The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery
Purpose Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activit...
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| Veröffentlicht in: | European spine journal 2020-07, Vol.29 (7), p.1597-1605 |
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| creator | Murata, Kazuma Matsuoka, Yuji Nishimura, Hirosuke Endo, Kenji Suzuki, Hidekazu Takamatsu, Taichiro Sawaji, Yasunobu Aihara, Takato Kusakabe, Takuya Maekawa, Asato Yamamoto, Kengo Watanabe, Kei Kaito, Takashi Terai, Hidetomi Tamai, Koji Tagami, Atushi Yoshii, Toshitaka Harimaya, Katsumi Kawaguchi, Kenichi Kimura, Atsushi Inoue, Gen Nakano, Atsushi Sakai, Daisuke Hiyama, Akihiko Ikegami, Shota Ohtori, Seiji Furuya, Takeo Orita, Sumihisa Imagama, Shiro Kobayashi, Kazuyoshi Kiyasu, Katsuhito Murakami, Hideki Yoshioka, Katsuhito Seki, Shoji Hongo, Michio Kakutani, Kenichiro Yurube, Takashi Aoki, Yasuchika Uei, Hiroshi Ajiro, Yasumitsu Takahata, Masahiko Endo, Hirooki Abe, Tetsuya Nakanishi, Kazuyoshi Watanabe, Kota Okada, Eijiro Hosogane, Naobumi Funao, Haruki Isogai, Norihiro Ishii, Ken |
| description | Purpose
Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.
Methods
We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.
Results
The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3;
P
|
| doi_str_mv | 10.1007/s00586-019-06092-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2272219651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2272219651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-deed0a42a7fcf7eeb29238ebcd5b5bfc9f6615df4d8dbce2a936ad0c61e2d7db3</originalsourceid><addsrcrecordid>eNp9kUFP3DAQha2Kqiy0f6CHyhKXXkLHTuLERwRtQVqpF3q2HHtcgrLxMnZA_HtMQ1uJQ0_jsb_3xprH2EcBpwKg-5IA2l5VIHQFCrSs4A3biKYuB13LA7YB3UClOqEP2VFKtwCi1aDescNaNCBU323Y_fUN8mBdjpQ44WQzep4jz-V6HyPxs4stH-e1t3nEOSf-MOYbHlPGuI8U8-j4PVLGgezEAxWzhZDbkJGKNGVadkVWxHHmaaFfSI_v2dtgp4QfXuox-_nt6_X5ZbX98f3q_Gxbubprc-URPdhG2i640CEOUsu6x8H5dmiH4HRQSrQ-NL73g0Npda2sB6cESt_5oT5mn1ffPcW7BVM2uzE5nCY7Y1ySkbKTUmjVioKevEJv40Jz-d0zBb2UZZOFkivlKKZEGMyexp2lRyPAPKdi1lRMScX8TsVAEX16sV6GHfq_kj8xFKBegVSe5rKgf7P_Y_sEuc2bUQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2270822671</pqid></control><display><type>article</type><title>The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery</title><source>SpringerLink Journals - AutoHoldings</source><creator>Murata, Kazuma ; Matsuoka, Yuji ; Nishimura, Hirosuke ; Endo, Kenji ; Suzuki, Hidekazu ; Takamatsu, Taichiro ; Sawaji, Yasunobu ; Aihara, Takato ; Kusakabe, Takuya ; Maekawa, Asato ; Yamamoto, Kengo ; Watanabe, Kei ; Kaito, Takashi ; Terai, Hidetomi ; Tamai, Koji ; Tagami, Atushi ; Yoshii, Toshitaka ; Harimaya, Katsumi ; Kawaguchi, Kenichi ; Kimura, Atsushi ; Inoue, Gen ; Nakano, Atsushi ; Sakai, Daisuke ; Hiyama, Akihiko ; Ikegami, Shota ; Ohtori, Seiji ; Furuya, Takeo ; Orita, Sumihisa ; Imagama, Shiro ; Kobayashi, Kazuyoshi ; Kiyasu, Katsuhito ; Murakami, Hideki ; Yoshioka, Katsuhito ; Seki, Shoji ; Hongo, Michio ; Kakutani, Kenichiro ; Yurube, Takashi ; Aoki, Yasuchika ; Uei, Hiroshi ; Ajiro, Yasumitsu ; Takahata, Masahiko ; Endo, Hirooki ; Abe, Tetsuya ; Nakanishi, Kazuyoshi ; Watanabe, Kota ; Okada, Eijiro ; Hosogane, Naobumi ; Funao, Haruki ; Isogai, Norihiro ; Ishii, Ken</creator><creatorcontrib>Murata, Kazuma ; Matsuoka, Yuji ; Nishimura, Hirosuke ; Endo, Kenji ; Suzuki, Hidekazu ; Takamatsu, Taichiro ; Sawaji, Yasunobu ; Aihara, Takato ; Kusakabe, Takuya ; Maekawa, Asato ; Yamamoto, Kengo ; Watanabe, Kei ; Kaito, Takashi ; Terai, Hidetomi ; Tamai, Koji ; Tagami, Atushi ; Yoshii, Toshitaka ; Harimaya, Katsumi ; Kawaguchi, Kenichi ; Kimura, Atsushi ; Inoue, Gen ; Nakano, Atsushi ; Sakai, Daisuke ; Hiyama, Akihiko ; Ikegami, Shota ; Ohtori, Seiji ; Furuya, Takeo ; Orita, Sumihisa ; Imagama, Shiro ; Kobayashi, Kazuyoshi ; Kiyasu, Katsuhito ; Murakami, Hideki ; Yoshioka, Katsuhito ; Seki, Shoji ; Hongo, Michio ; Kakutani, Kenichiro ; Yurube, Takashi ; Aoki, Yasuchika ; Uei, Hiroshi ; Ajiro, Yasumitsu ; Takahata, Masahiko ; Endo, Hirooki ; Abe, Tetsuya ; Nakanishi, Kazuyoshi ; Watanabe, Kota ; Okada, Eijiro ; Hosogane, Naobumi ; Funao, Haruki ; Isogai, Norihiro ; Ishii, Ken</creatorcontrib><description>Purpose
Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.
Methods
We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.
Results
The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.006), absence of preoperative bone-modifying agent (BMA) administration (OR, 2.7;
P
= 0.03), and absence of postoperative recombinant human parathyroid hormone (rPTH) administration (OR, 3.9;
P
= 0.006) were significantly associated. In multivariate analysis, preoperative neurological deficit (OR, 4.6;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.01), and absence of postoperative rPTH administration (OR, 3.9;
P
= 0.02) showed statistical significance.
Conclusions
Preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration were considered as predictors for postoperative poor ADL in patients with OVF. Neurological deficits and complications are often inevitable factors; therefore, rPTH is an important option for postoperative treatment for OVF.
Graphic abstract
These slides can be retrieved under Electronic Supplementary Material.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-019-06092-0</identifier><identifier>PMID: 31401687</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Fractures ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Neurological complications ; Neurological diseases ; Neurosurgery ; Nonunion ; Original Article ; Osteoporosis ; Parathyroid ; Parathyroid hormone ; Patients ; Statistical analysis ; Statistics ; Surgery ; Surgical Orthopedics ; Vertebrae</subject><ispartof>European spine journal, 2020-07, Vol.29 (7), p.1597-1605</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-deed0a42a7fcf7eeb29238ebcd5b5bfc9f6615df4d8dbce2a936ad0c61e2d7db3</citedby><cites>FETCH-LOGICAL-c375t-deed0a42a7fcf7eeb29238ebcd5b5bfc9f6615df4d8dbce2a936ad0c61e2d7db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-019-06092-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-019-06092-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31401687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murata, Kazuma</creatorcontrib><creatorcontrib>Matsuoka, Yuji</creatorcontrib><creatorcontrib>Nishimura, Hirosuke</creatorcontrib><creatorcontrib>Endo, Kenji</creatorcontrib><creatorcontrib>Suzuki, Hidekazu</creatorcontrib><creatorcontrib>Takamatsu, Taichiro</creatorcontrib><creatorcontrib>Sawaji, Yasunobu</creatorcontrib><creatorcontrib>Aihara, Takato</creatorcontrib><creatorcontrib>Kusakabe, Takuya</creatorcontrib><creatorcontrib>Maekawa, Asato</creatorcontrib><creatorcontrib>Yamamoto, Kengo</creatorcontrib><creatorcontrib>Watanabe, Kei</creatorcontrib><creatorcontrib>Kaito, Takashi</creatorcontrib><creatorcontrib>Terai, Hidetomi</creatorcontrib><creatorcontrib>Tamai, Koji</creatorcontrib><creatorcontrib>Tagami, Atushi</creatorcontrib><creatorcontrib>Yoshii, Toshitaka</creatorcontrib><creatorcontrib>Harimaya, Katsumi</creatorcontrib><creatorcontrib>Kawaguchi, Kenichi</creatorcontrib><creatorcontrib>Kimura, Atsushi</creatorcontrib><creatorcontrib>Inoue, Gen</creatorcontrib><creatorcontrib>Nakano, Atsushi</creatorcontrib><creatorcontrib>Sakai, Daisuke</creatorcontrib><creatorcontrib>Hiyama, Akihiko</creatorcontrib><creatorcontrib>Ikegami, Shota</creatorcontrib><creatorcontrib>Ohtori, Seiji</creatorcontrib><creatorcontrib>Furuya, Takeo</creatorcontrib><creatorcontrib>Orita, Sumihisa</creatorcontrib><creatorcontrib>Imagama, Shiro</creatorcontrib><creatorcontrib>Kobayashi, Kazuyoshi</creatorcontrib><creatorcontrib>Kiyasu, Katsuhito</creatorcontrib><creatorcontrib>Murakami, Hideki</creatorcontrib><creatorcontrib>Yoshioka, Katsuhito</creatorcontrib><creatorcontrib>Seki, Shoji</creatorcontrib><creatorcontrib>Hongo, Michio</creatorcontrib><creatorcontrib>Kakutani, Kenichiro</creatorcontrib><creatorcontrib>Yurube, Takashi</creatorcontrib><creatorcontrib>Aoki, Yasuchika</creatorcontrib><creatorcontrib>Uei, Hiroshi</creatorcontrib><creatorcontrib>Ajiro, Yasumitsu</creatorcontrib><creatorcontrib>Takahata, Masahiko</creatorcontrib><creatorcontrib>Endo, Hirooki</creatorcontrib><creatorcontrib>Abe, Tetsuya</creatorcontrib><creatorcontrib>Nakanishi, Kazuyoshi</creatorcontrib><creatorcontrib>Watanabe, Kota</creatorcontrib><creatorcontrib>Okada, Eijiro</creatorcontrib><creatorcontrib>Hosogane, Naobumi</creatorcontrib><creatorcontrib>Funao, Haruki</creatorcontrib><creatorcontrib>Isogai, Norihiro</creatorcontrib><creatorcontrib>Ishii, Ken</creatorcontrib><title>The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.
Methods
We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.
Results
The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.006), absence of preoperative bone-modifying agent (BMA) administration (OR, 2.7;
P
= 0.03), and absence of postoperative recombinant human parathyroid hormone (rPTH) administration (OR, 3.9;
P
= 0.006) were significantly associated. In multivariate analysis, preoperative neurological deficit (OR, 4.6;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.01), and absence of postoperative rPTH administration (OR, 3.9;
P
= 0.02) showed statistical significance.
Conclusions
Preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration were considered as predictors for postoperative poor ADL in patients with OVF. Neurological deficits and complications are often inevitable factors; therefore, rPTH is an important option for postoperative treatment for OVF.
Graphic abstract
These slides can be retrieved under Electronic Supplementary Material.</description><subject>Fractures</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Neurological complications</subject><subject>Neurological diseases</subject><subject>Neurosurgery</subject><subject>Nonunion</subject><subject>Original Article</subject><subject>Osteoporosis</subject><subject>Parathyroid</subject><subject>Parathyroid hormone</subject><subject>Patients</subject><subject>Statistical analysis</subject><subject>Statistics</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Vertebrae</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUFP3DAQha2Kqiy0f6CHyhKXXkLHTuLERwRtQVqpF3q2HHtcgrLxMnZA_HtMQ1uJQ0_jsb_3xprH2EcBpwKg-5IA2l5VIHQFCrSs4A3biKYuB13LA7YB3UClOqEP2VFKtwCi1aDescNaNCBU323Y_fUN8mBdjpQ44WQzep4jz-V6HyPxs4stH-e1t3nEOSf-MOYbHlPGuI8U8-j4PVLGgezEAxWzhZDbkJGKNGVadkVWxHHmaaFfSI_v2dtgp4QfXuox-_nt6_X5ZbX98f3q_Gxbubprc-URPdhG2i640CEOUsu6x8H5dmiH4HRQSrQ-NL73g0Npda2sB6cESt_5oT5mn1ffPcW7BVM2uzE5nCY7Y1ySkbKTUmjVioKevEJv40Jz-d0zBb2UZZOFkivlKKZEGMyexp2lRyPAPKdi1lRMScX8TsVAEX16sV6GHfq_kj8xFKBegVSe5rKgf7P_Y_sEuc2bUQ</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Murata, Kazuma</creator><creator>Matsuoka, Yuji</creator><creator>Nishimura, Hirosuke</creator><creator>Endo, 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Toshitaka ; Harimaya, Katsumi ; Kawaguchi, Kenichi ; Kimura, Atsushi ; Inoue, Gen ; Nakano, Atsushi ; Sakai, Daisuke ; Hiyama, Akihiko ; Ikegami, Shota ; Ohtori, Seiji ; Furuya, Takeo ; Orita, Sumihisa ; Imagama, Shiro ; Kobayashi, Kazuyoshi ; Kiyasu, Katsuhito ; Murakami, Hideki ; Yoshioka, Katsuhito ; Seki, Shoji ; Hongo, Michio ; Kakutani, Kenichiro ; Yurube, Takashi ; Aoki, Yasuchika ; Uei, Hiroshi ; Ajiro, Yasumitsu ; Takahata, Masahiko ; Endo, Hirooki ; Abe, Tetsuya ; Nakanishi, Kazuyoshi ; Watanabe, Kota ; Okada, Eijiro ; Hosogane, Naobumi ; Funao, Haruki ; Isogai, Norihiro ; Ishii, Ken</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-deed0a42a7fcf7eeb29238ebcd5b5bfc9f6615df4d8dbce2a936ad0c61e2d7db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Fractures</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Neurological complications</topic><topic>Neurological diseases</topic><topic>Neurosurgery</topic><topic>Nonunion</topic><topic>Original Article</topic><topic>Osteoporosis</topic><topic>Parathyroid</topic><topic>Parathyroid hormone</topic><topic>Patients</topic><topic>Statistical analysis</topic><topic>Statistics</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murata, Kazuma</creatorcontrib><creatorcontrib>Matsuoka, Yuji</creatorcontrib><creatorcontrib>Nishimura, Hirosuke</creatorcontrib><creatorcontrib>Endo, Kenji</creatorcontrib><creatorcontrib>Suzuki, Hidekazu</creatorcontrib><creatorcontrib>Takamatsu, Taichiro</creatorcontrib><creatorcontrib>Sawaji, Yasunobu</creatorcontrib><creatorcontrib>Aihara, Takato</creatorcontrib><creatorcontrib>Kusakabe, Takuya</creatorcontrib><creatorcontrib>Maekawa, 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Katsuhito</creatorcontrib><creatorcontrib>Murakami, Hideki</creatorcontrib><creatorcontrib>Yoshioka, Katsuhito</creatorcontrib><creatorcontrib>Seki, Shoji</creatorcontrib><creatorcontrib>Hongo, Michio</creatorcontrib><creatorcontrib>Kakutani, Kenichiro</creatorcontrib><creatorcontrib>Yurube, Takashi</creatorcontrib><creatorcontrib>Aoki, Yasuchika</creatorcontrib><creatorcontrib>Uei, Hiroshi</creatorcontrib><creatorcontrib>Ajiro, Yasumitsu</creatorcontrib><creatorcontrib>Takahata, Masahiko</creatorcontrib><creatorcontrib>Endo, Hirooki</creatorcontrib><creatorcontrib>Abe, Tetsuya</creatorcontrib><creatorcontrib>Nakanishi, Kazuyoshi</creatorcontrib><creatorcontrib>Watanabe, Kota</creatorcontrib><creatorcontrib>Okada, Eijiro</creatorcontrib><creatorcontrib>Hosogane, Naobumi</creatorcontrib><creatorcontrib>Funao, Haruki</creatorcontrib><creatorcontrib>Isogai, Norihiro</creatorcontrib><creatorcontrib>Ishii, Ken</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murata, Kazuma</au><au>Matsuoka, Yuji</au><au>Nishimura, Hirosuke</au><au>Endo, Kenji</au><au>Suzuki, Hidekazu</au><au>Takamatsu, Taichiro</au><au>Sawaji, Yasunobu</au><au>Aihara, Takato</au><au>Kusakabe, Takuya</au><au>Maekawa, Asato</au><au>Yamamoto, Kengo</au><au>Watanabe, Kei</au><au>Kaito, Takashi</au><au>Terai, Hidetomi</au><au>Tamai, Koji</au><au>Tagami, Atushi</au><au>Yoshii, Toshitaka</au><au>Harimaya, Katsumi</au><au>Kawaguchi, Kenichi</au><au>Kimura, Atsushi</au><au>Inoue, Gen</au><au>Nakano, Atsushi</au><au>Sakai, Daisuke</au><au>Hiyama, Akihiko</au><au>Ikegami, Shota</au><au>Ohtori, Seiji</au><au>Furuya, Takeo</au><au>Orita, Sumihisa</au><au>Imagama, Shiro</au><au>Kobayashi, Kazuyoshi</au><au>Kiyasu, Katsuhito</au><au>Murakami, Hideki</au><au>Yoshioka, Katsuhito</au><au>Seki, Shoji</au><au>Hongo, Michio</au><au>Kakutani, Kenichiro</au><au>Yurube, Takashi</au><au>Aoki, Yasuchika</au><au>Uei, Hiroshi</au><au>Ajiro, Yasumitsu</au><au>Takahata, Masahiko</au><au>Endo, Hirooki</au><au>Abe, Tetsuya</au><au>Nakanishi, Kazuyoshi</au><au>Watanabe, Kota</au><au>Okada, Eijiro</au><au>Hosogane, Naobumi</au><au>Funao, Haruki</au><au>Isogai, Norihiro</au><au>Ishii, Ken</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>29</volume><issue>7</issue><spage>1597</spage><epage>1605</epage><pages>1597-1605</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.
Methods
We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.
Results
The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.006), absence of preoperative bone-modifying agent (BMA) administration (OR, 2.7;
P
= 0.03), and absence of postoperative recombinant human parathyroid hormone (rPTH) administration (OR, 3.9;
P
= 0.006) were significantly associated. In multivariate analysis, preoperative neurological deficit (OR, 4.6;
P
< 0.001), perioperative complication (OR, 3.4;
P
= 0.01), and absence of postoperative rPTH administration (OR, 3.9;
P
= 0.02) showed statistical significance.
Conclusions
Preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration were considered as predictors for postoperative poor ADL in patients with OVF. Neurological deficits and complications are often inevitable factors; therefore, rPTH is an important option for postoperative treatment for OVF.
Graphic abstract
These slides can be retrieved under Electronic Supplementary Material.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31401687</pmid><doi>10.1007/s00586-019-06092-0</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0940-6719 |
| ispartof | European spine journal, 2020-07, Vol.29 (7), p.1597-1605 |
| issn | 0940-6719 1432-0932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2272219651 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Fractures Medicine Medicine & Public Health Multivariate analysis Neurological complications Neurological diseases Neurosurgery Nonunion Original Article Osteoporosis Parathyroid Parathyroid hormone Patients Statistical analysis Statistics Surgery Surgical Orthopedics Vertebrae |
| title | The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery |
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