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The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery

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Abstract

Purpose

Osteoporotic vertebral fracture (OVF) with nonunion or neurological deficit may be a candidate for surgical treatment. However, some patients do not show improvement as expected. Therefore, we conducted a nationwide multicenter study to determine the predictors for postoperative poor activity of daily living (ADL) in patients with OVF.

Methods

We retrospectively reviewed the case histories of 309 patients with OVF who underwent surgery. To determine the factors predicting postoperative poor ADL, uni- and multivariate statistical analyses were performed.

Results

The frequency of poor ADL at final follow-up period was 9.1%. In univariate analysis, preoperative neurological deficit (OR, 4.1; 95% CI, 1.8–10.3; P < 0.001), perioperative complication (OR, 3.4; P = 0.006), absence of preoperative bone-modifying agent (BMA) administration (OR, 2.7; P = 0.03), and absence of postoperative recombinant human parathyroid hormone (rPTH) administration (OR, 3.9; P = 0.006) were significantly associated. In multivariate analysis, preoperative neurological deficit (OR, 4.6; P < 0.001), perioperative complication (OR, 3.4; P = 0.01), and absence of postoperative rPTH administration (OR, 3.9; P = 0.02) showed statistical significance.

Conclusions

Preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration were considered as predictors for postoperative poor ADL in patients with OVF. Neurological deficits and complications are often inevitable factors; therefore, rPTH is an important option for postoperative treatment for OVF.

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Acknowledgements

The authors are indebted to the medical editors from the Department of International Medical Communications of Tokyo Medical University for editing and reviewing the initial English manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shijjuku-ku, Tokyo, 160-0023, Japan

    Kazuma Murata, Yuji Matsuoka, Hirosuke Nishimura, Kenji Endo, Hidekazu Suzuki, Taichiro Takamatsu, Yasunobu Sawaji, Takato Aihara, Takuya Kusakabe, Asato Maekawa & Kengo Yamamoto

  2. Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata-shi, Niigata, 951-8510, Japan

    Kei Watanabe

  3. Osaka University, 2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan

    Takashi Kaito

  4. Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Hidetomi Terai & Koji Tamai

  5. Nagasaki University, 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki, 852-8501, Japan

    Atushi Tagami

  6. Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Toshitaka Yoshii

  7. Kyusyu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka, 812-8582, Japan

    Katsumi Harimaya & Kenichi Kawaguchi

  8. Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan

    Atsushi Kimura

  9. Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa, 252-0374, Japan

    Gen Inoue

  10. Osaka Medical College, 2-7 Daigakumachi, Tskatsuki-shi, Osaka, 569-0801, Japan

    Atsushi Nakano

  11. Tokai University, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1193, Japan

    Daisuke Sakai & Akihiko Hiyama

  12. Shinshu University, 3-1-1 Asahi, Matsumoto-shi, Nagano, 390-8621, Japan

    Shota Ikegami

  13. Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan

    Seiji Ohtori, Takeo Furuya & Sumihisa Orita

  14. Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya-shi, Aichi, 466-8560, Japan

    Shiro Imagama & Kazuyoshi Kobayashi

  15. Kochi University, 185-1 Kohasu, Okaho-cho, Nankoku-shi, Kochi, 783-8505, Japan

    Katsuhito Kiyasu

  16. Kanazawa University, 13-1 Takaramachi, Kanazawa-shi, Ishikawa, 920-0934, Japan

    Hideki Murakami & Katsuhito Yoshioka

  17. University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan

    Shoji Seki

  18. Akita University, 1-1-1 Hondo, Akita-shi, Akita, 010-8543, Japan

    Michio Hongo

  19. Kobe University, 7-5-1 Kusunoki-cho, Chuou-ku, Kobe-shi, Hyogo, 650-0017, Japan

    Kenichiro Kakutani & Takashi Yurube

  20. Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane-shi, Chiba, 283-8686, Japan

    Yasuchika Aoki

  21. Nihon University, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan

    Hiroshi Uei & Yasumitsu Ajiro

  22. Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo-shi, Hokkaido, 060-8683, Japan

    Masahiko Takahata

  23. Iwate Medical University, 19-1 Uchimaru, Morioka-shi, Iwate, 020-8505, Japan

    Hirooki Endo

  24. University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, 305-8577, Japan

    Tetsuya Abe

  25. Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Kazuyoshi Nakanishi

  26. Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kota Watanabe & Eijiro Okada

  27. Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan

    Naobumi Hosogane

  28. International University of Health and Welfare, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan

    Haruki Funao, Norihiro Isogai & Ken Ishii

Authors
  1. Kazuma Murata
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  2. Yuji Matsuoka
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  3. Hirosuke Nishimura
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  4. Kenji Endo
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  5. Hidekazu Suzuki
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  6. Taichiro Takamatsu
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  7. Yasunobu Sawaji
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  8. Takato Aihara
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  9. Takuya Kusakabe
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  10. Asato Maekawa
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  11. Kengo Yamamoto
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  12. Kei Watanabe
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  13. Takashi Kaito
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  14. Hidetomi Terai
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  15. Koji Tamai
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  16. Atushi Tagami
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  17. Toshitaka Yoshii
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  18. Katsumi Harimaya
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  19. Kenichi Kawaguchi
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  20. Atsushi Kimura
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  21. Gen Inoue
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  22. Atsushi Nakano
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  33. Katsuhito Yoshioka
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  34. Shoji Seki
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  35. Michio Hongo
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  36. Kenichiro Kakutani
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  37. Takashi Yurube
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  38. Yasuchika Aoki
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  39. Hiroshi Uei
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  40. Yasumitsu Ajiro
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  41. Masahiko Takahata
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  42. Hirooki Endo
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  43. Tetsuya Abe
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  44. Kazuyoshi Nakanishi
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  45. Kota Watanabe
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  46. Eijiro Okada
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  47. Naobumi Hosogane
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  48. Haruki Funao
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  49. Norihiro Isogai
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  50. Ken Ishii
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Corresponding author

Correspondence to Kazuma Murata.

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Murata, K., Matsuoka, Y., Nishimura, H. et al. The factors related to the poor ADL in the patients with osteoporotic vertebral fracture after instrumentation surgery. Eur Spine J 29, 1597–1605 (2020). https://doi.org/10.1007/s00586-019-06092-0

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