The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis

Kubat, Ozren

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doctoral thesis

The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis

Zagreb: University of Zagreb, School of Medicine, 2021. urn:nbn:hr:105:042426

Kubat, Ozren

University of Zagreb
School of Medicine

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APA 6th Edition

Kubat, O. (2021). The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis (Doctoral thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:042426

MLA 8th Edition

Kubat, Ozren. "The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis." Doctoral thesis, University of Zagreb, School of Medicine, 2021. https://urn.nsk.hr/urn:nbn:hr:105:042426

Chicago 17th Edition

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Kubat, O. (2021). 'The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis', Doctoral thesis, University of Zagreb, School of Medicine, accessed 30 September 2023, https://urn.nsk.hr/urn:nbn:hr:105:042426

Vancouver

Kubat O. The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis [Doctoral thesis]. Zagreb: University of Zagreb, School of Medicine; 2021 [cited 2023 September 30] Available at: https://urn.nsk.hr/urn:nbn:hr:105:042426

IEEE

O. Kubat, "The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis", Doctoral thesis, University of Zagreb, School of Medicine, Zagreb, 2021. Available at: https://urn.nsk.hr/urn:nbn:hr:105:042426

Cite this item: https://urn.nsk.hr/urn:nbn:hr:105:042426

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Title	The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis
Title (english)	The effect of spinopelvic parameters on the development of proximal junctional kyphosis in early onset scoliosis
Author	Ozren Kubat
Mentor	Domagoj Delimar (mentor)
Committee member	Tomislav Smoljanović (predsjednik povjerenstva)
Committee member	Boris Brkljačić (član povjerenstva)
Committee member	Tomislav Đapić (član povjerenstva)
Granter	University of Zagreb School of Medicine Zagreb
Defense date and country	2021-07-08, Croatia
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Orthopedics
Universal decimal classification (UDC)	612 - Physiology
Abstract	Pre- and postoperative spinopelvic anatomy can influence results of distraction treatment in early onset scoliosis. I hypothesize patients with abnormal spinopelvic alignment have increased risk of proximal junctional kyphosis (PJK) during distraction treatment. Patients were treated between April 1997 and August 2014. A subsegment of patients were evaluated for quality of life. 135 patients were treated at an average age of 5.3 ± 2.83 years (range, 0.97-12.18), with minimum 2-year follow-up (average, 4.5 ± 2.6 years). 96 of 135 were included in the radiographic PJK study. 89 rib- and 46 spine-based distraction implants were used.Radiographic PJK developed in 38%, and clinical PJK in 18% of patients. Only pre-operative TK >50º increased risk for radiographic PJK (RR: 1.667, P=0.04). Pre-operative spinopelvic parameters did not increase risk for clinical PJK. Regarding quality of life, pelvic incidence –lumbar lordosis (PI-LL) mismatch > ±20o increased risk for poor outcomes through multiple domains while pelvic tilt (PT) >30°, implant type or fusion to pelvis had no effect. Preoperative TK >50º and spine-based distraction construct increased risk of radiographic PJK, and postoperative PI-LL >20º and PT ≥30º increased risk for clinical PJK. Preoperative PI >60° was shown to increase pain.
Abstract (croatian)	Pre- i postoperativna spinopelvina anatomija utječu na rezultate liječenja djece s ranopojavnom skoliozom. Hipoteza predmnijeva da bolesnici s abnormalnom spinopelvinom anatomijom imaju veći rizik od nastanka kifoze proksimalnog spoja (KPS) u tijeku liječenja rastućim instrumentacijama. Ova studija obuhvatila je bolesnike liječene od travnja 1997. do kolovoza 2014. Kod dijela bolesnika evaluirana je i kvaliteta života. 135 bolesnika liječeno je u prosječnoj dobi od 5,3 ± 2,83 godina (raspon, 0,97-12,18) s minimalnim praćenjem od 2 godine (prosjek, 4,5 ± 2,6 godina). 96 bolesnika uključeno je u ispitivanje radiografske kifoze. Ukupno je upotrijebljeno 89 kralježničnih i 46 rebrenih instrumentacija. Radiografska KPS pronađena je u 38% (36/96), dok je ona klinički značajna otkrivena u 18% (24/135) bolesnika. Preoperativna torakalna kifoza (TK) >50° povećala je rizik za radiografsku KPS (RR: 1.667, P=0.04), dok preoperativni spinopelvini parametri nisu utjecali na razvoj klinički značajne kifoze. Utjecaj navedenih anatomskih varijanti na kvalitetu života bio je slijedeći: razlika incidence zdjelice i lordoze (eng. pelvic incidence lumbar lordosis mismatch (PI-LL)) >20° uzrokuje loš rezultat u multiplim domenama, nagib zdjelice (eng. pelvic tilt (PT)) >30°. Preoperativna TK >50° i kralježnične instrumentacije povećavaju rizik pojave radiografske kifoze, a postoperativni PI-LL >20° i PT ≥30º povećavaju rizik od klinički značajne kifoze. Preoperativna PI >60° uzrokuje bolove.
Keywords
Keywords (croatian)
Language	english
URN:NBN	urn:nbn:hr:105:042426
Study programme	Title: Biomedicine and Health Sciences Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource	Text
Extent	81 str.
File origin	Born digital
Access conditions	Open access
Terms of use
Public note	Sumentor: Ron El-Hawary
Repository	Dr Med - University of Zagreb School of Medicine Digital Repository
Created on	2021-11-02 08:18:27