Artikel
Influence of sagittal angles for reoperation rates after dynamic stabilization with the Cosmic®-system
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Autoren
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Franziska Schmidt
- Klinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, München
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Michael Behr
- Klinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, München
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Bernhard Meyer
- Klinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, München
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Sandro M. Krieg
- Klinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, München
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: There are no known factors predicting reoperation after dynamic stabilization up to now. We propose a dependency of the screw angles on the need for reoperation. The object of this study was to evaluate the influence of sagittal angles for reoperations to investigate potential impacts.
Method: Between January 2008 and December 2011, 283 patients (f:m 151:132) were enrolled in this analysis. All patients were subject to dynamic stabilization with the Cosmic®-system with a median follow-up of 46 months. The median age was 68 (range 31 - 86) years.
All patients underwent computed tomography or x-ray after surgery. The angles between the two screws were measured for each vertebra in each patient. Furthermore the angles between two adjacent segments were measured. According to the indication for reoperation the patients were divided into three groups: patients with screw loosening (n= 23), patients with adjacent segment disease (ASD) (n= 30) and patients without any reoperation (n= 213).
Results: For patients with screw loosening: Median deviation angle was 3.80 ± 2.28° in patients with reoperation and 4.58 ± 2.61°) in patients without reoperation. Median screw angle was 18.40 ± 4.80° in patients with reoperation and 19.50 ± 4.91° in patients without reoperation. There was no correlation between deviation angle and reoperation (p=0.13) as well as screw angle and reoperation (p=0.21).
For patients with ASD: Median deviation angle was 4.55 ± 3.72° in patients with reoperation and 4.58 ± 2.61° in patients without reoperation. Median screw angle was 18.50 ± 6.22° in patients with reoperation and 19.50 ± 4.91° in patients without reoperation. No correlation was observed between deviation angle and reoperation (p=0.57) as well as screw angle and reoperation rate (p=0.65) for patients with ASD.
Conclusions: This data set suggests that reoperation rate is not correlated to the angles between screws within the segment or even the angles between adjacent segments.
