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- 저자 : Muramatsu Yuta (검색결과 1 건)
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Risk Factors for Loosening of S2 Alar Iliac Screw: Surgical Outcomes of Adult Spinal Deformity
Iijima Yasushi,Kotani Toshiaki,Sakuma Tsuyoshi,Nakayama Keita,Akazawa Tsutomu,Kishida Shunji,Muramatsu Yuta,Sasaki Yu,Ueno Keisuke,Asada Tomoyuki,Sato Kosuke,Minami Shohei,Ohtori Seiji 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.6
Study Design: Retrospective study.Purpose: To determine the risk factors for S2 alar iliac (S2AI) screw loosening and its association with lumbosacral fusion in patients with adult spinal deformity (ASD).Overview of Literature: S2AI screws have been widely used for ASD surgery in recent years. However, no studies have analyzed the risk factors for loosening of S2AI screws and its association with lumbosacral fusion.Methods: Cases of 50 patients with ASD who underwent long spinal fusion (>9 levels) with S2AI screws were retrospectively reviewed. Loosening of S2AI screws and S1 pedicle screws and bone fusion at the level of L5–S1 at 2 years after surgery were investigated using computed tomography. In addition, risk factors for loosening of S2AI screws were determined in patients with ASD. Results: At 2 years after surgery, 33 cases (66%) of S2AI screw loosening and six cases (12%) of S1 pedicle screw loosening were observed. In 40 of 47 cases (85%), bone fusion at L5–S1 was found. Pseudarthrosis at L5–S1 was not significantly associated with S2AI screw loosening (19.3% vs. 6.3%, <i>p</i>=0.23), but significantly higher in patients with S1 screw loosening (83.3% vs. 4.9%, <i>p</i><0.001). On multivariate logistic regression analyses, high upper instrumented vertebra (UIV) level (T5 or above) (odds ratio [OR], 4.4; 95% confidence interval [CI], 1.0–18.6; <i>p</i>=0.045) and obesity (OR, 11.4; 95% CI, 1.2–107.2; <i>p</i>=0.033) were independent risk factors for S2AI screw loosening.Conclusions: High UIV level (T5 or above) and obesity were independent risk factors for S2AI screw loosening in patients with lumbosacral fixation in surgery for ASD. The incidence of lumbosacral fusion is associated with S1 screw loosening, but not S2AI screw loosening.
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