Comparison of Short-Segment Versus Long-Segment Fixation in Posterior Osteotomy for Kyphotic Deformity: Effects on Postoperative Alignment and Complications
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Abstract
Background: Posterior osteotomy is an effective treatment for severe kyphosis; however, postoperative complications, particularly early radiographic proximal junctional kyphosis (PJK), may compromise outcomes. Evidence regarding factors influencing postoperative efficacy and complication risk remains limited. Objective: To compare the clinical efficacy of long-segment versus short-segment fixation in posterior osteotomy for kyphosis and identify factors affecting outcomes and complications. Methods: This retrospective controlled study included 150 patients undergoing posterior thoracolumbar osteotomy with fusion and internal fixation between June 2019 and June 2023. Patients were grouped by fixation length: long-segment (group L, ≥5 segments) and short-segment (group S, ≤4 segments). Propensity score matching balanced baseline characteristics, yielding 50 patients per group. Radiographic parameters (Cobb angle, sagittal vertical axis), perioperative data, and 12-month complications were recorded. Pain and function were assessed using VAS and ODI. Multivariate logistic regression identified independent risk factors for correction loss and early radiographic PJK. Results: Both groups showed significant postoperative improvement in Cobb angle and sagittal alignment (P<0.05). Group L achieved a higher correction rate, lower Cobb angle loss, better VAS and ODI scores, and fewer early radiographic PJK and fixation-related complications (all P<0.05). Group S had shorter operative time and less blood loss (P<0.05), with no difference in other complications. Short-segment fixation was independent risk factors for correction loss and early radiographic PJK. Conclusion: When correcting spinal kyphosis via posterior osteotomy, long-segment fixation better maintains correction and reduces complications like early radiographic PJK, while junctional kyphosis 删除[Author]: junctional kyphosis 删除[Author]: junctional kyphosis 删除[Author]: , BMD T-score <−2.5, and age >60 years 删除[Author]: ere 删除[Author]: junctional kyphosis 删除[Author]: short-segment fixation shortens surgery time but increases risks of correction loss and early radiographic PJK.
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imported_1768900576_696f47e02d6a1
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| Authors | Li, Qiang |
| Journal | Frontiers in surgery |
| Year | Year not found |
| DOI |
10.3389/fsurg.2026.1771214
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| Keywords | Keywords not found |
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