Two-level cement augmentation may decrease acute proximal junctional fracture rate — 4 key points

In a study published in Spine, researchers found use of two-level cement augmentation was linked with a significant reduction in the incidence of proximal junction fractures and revision procedures in patients with adult spinal deformity.

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Researchers retrospectively studied data on 51 patients with adult spinal deformity after thoracolumbar fusion from the pelvis to thoracolumbar junction with at least six months of follow-up. Health-related quality of life outcomes, demographics and radiograph parameters of deformity were compared for patients who underwent the following procedures:

 

• No cement
• Two-level cement augmentation at upper instrumented vertebra and vertebra one level proximal to UIV
• Cement at another location

 

Here are four key points:

 

1. A total of 19 patients underwent two-level cement augmentation at UIV, 23 patients had no cement and nine patients underwent cement at another location.

 

2. Researchers found that two-level procedures without cement had a 19 percent revision rate for proximal junctional fractures compared with a 0 percent revision rate for two-level procedures with cement.

 

3. When adjusted for UIV, the risk of proximal junction fracture revision surgery increased by 13.1-times for the “other” category of patients.

 

4. In addition, two-level cement increased HRQoLs in all patients, while only back and leg pain significantly improved in non-two-level cement procedures.

 

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