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- 저자 : Christian Krettek (검색결과 2 건)
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Sebastian Decker,Renaud Lafage,Christian Krettek,Robert Hart,Christopher Ames,Justin S. Smith,Douglas Burton,Eric Klineberg,Shay Bess,Frank J. Schwab,Virginie Lafage,International Spine Study Group 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2
Study Design: Retrospective cohort study. Purpose: To investigate the role of sacral extension (SE) for the development of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) surgery. Overview of Literature: The development of PJK is multifactorial and different risk factors have been identified. Of these, there is some evidence that SE also affects the development of PJK, but data are insufficient. Methods: Using a combined database comprising two propensity-matched groups of fusions following ASD surgery, one with fixation to S1 or S1 and the ilium (SE) and one without SE but with a lower instrumented vertebra of L5 or higher (lumbar fixation, LF), PJK and the role of further parameters were analyzed. The propensity-matched variables included age, the upper-most instrumented vertebra (UIV), preoperative sagittal alignment, and the baseline to 1 year change of the sagittal alignment. Results: Propensity matching led to two groups of 89 patients each. The UIV, pelvic incidence minus lumbar lordosis, sagittal vertical axis, pelvic tilt, age, and body mass index were similar in both groups (p>0.05). The incidence of PJK at postoperative 1 year was similar for SE (30.3%) and LF (22.5%) groups (p=0.207). The PJK angle was comparable (p=0.963) with a change of −8.2° (SE) and −8.3° (LF) from the preoperative measures (p=0.954). A higher rate of PJK after SE (p=0.026) was found only in the subgroup of patients with UIV levels between T9 and T12. Conclusions: Instrumentation to the sacrum with or without iliac extension did not increase the overall risk of PJK. However, an increased risk for PJK was found after SE with UIV levels between T9 and T12.
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Marcel Winkelmann,Thassia Mavropoulos,Sebastian Decker,Mohamed Omar,Christian Krettek,Christian Walter Müller 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.5
Study Design: Retrospective cohort analysis Purpose: Comparison of balloon kyphoplasty (BKP) and radiofrequency kyphoplasty (RFK) with respect to height restoration of the fractured vertebral bodies and the pain relief experienced after the surgical procedure. Overview of Literature: BKP and RFK both offer safe, time-saving, and potent treatment options for vertebral compression fractures, but neither of these methods demonstrated any key advantage over the other yet. Methods: We performed a retrospective analysis of a cohort of 156 patients (mean age, 73±11 years) with 252 fractured vertebral bodies treated with kyphoplasty. Pain intensity was measured using a Visual Analogue Scale. Preoperative and postoperative computed tomography images were analyzed and gauged using modified bisegmental Cobb angle, vertebral angle, as well as anterior (Ha), middle (Hm), and posterior (Hp) vertebral body heights. Results: The mean postoperative pain relief was 5.1±1.8, which was maintained over the entire follow-up period. There were no significant differences in the pain relief between BKP and RFK. Postoperative changes in the vertebral angle (−1.3°±3.3°, p <0.001) and Ha, Hm, and Hp vertebral body heights (Ha, 1.5±2.9 mm; Hm, 2.1±2.9 mm; Hp, 0.9±2.1 mm; p <0.001) were significant. However, the initial height restoration could not be maintained by the 6-week and 1-year follow-up. Neither BKP nor RFK could achieve a clinically relevant advantage over each other. There was no correlation between pain relief and height restoration after kyphoplasty. Conclusions: Both BKP and RFK had comparable beneficial clinical and radiological effects in the treatment of vertebral compression fractures. However, neither the actual extent of height restoration nor its loss seems to affect the marked pain relief.
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