Effectiveness of posterior structures in the development of proximal junctional kyphosis following posterior instrumentation: A biomechanical study in a sheep spine model

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dc.authoridOkan Özkunt / 0000-0002-6768-959X
dc.authorscopusidOkan Özkunt / 55890597400
dc.authorwosidOkan Özkunt / DLS-5829-2022
dc.contributor.authorKorkmaz, Murat
dc.contributor.authorAkgül, Turgut
dc.contributor.authorSarıyılmaz, Kerim
dc.contributor.authorÖzkunt, Okan
dc.contributor.authorDikici, Fatih
dc.contributor.authorYazıcıoğlu, Önder
dc.date.accessioned2020-08-30T20:06:34Z
dc.date.available2020-08-30T20:06:34Z
dc.date.issued2019
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.description.abstractIntroduction: Proximal junctional kyphosis - PJK has been defined by a 10 or greater increase in kyphosis at the proximal junction as measured by the Cobb angle from the caudal endplate of the uppermost instrumented vertebrae (UIV) to the cephalad endplate of the vertebrae 1 segments cranial to the UIV. In this biomechanical study, it is aimed to evaluate effects of interspinosus ligament complex distruption and facet joint degeneration on PJK development. Materials and methods: Posterior instrumentation applied between T2 - T7 vertebrae using pedicle screws to randomly selected 21 sheeps, divided into 3 groups. First group selected as control group (CG), of which posterior soft tissue and facet joints are protected. In second group (spinosus group, SG) interspinosus ligament complex which 1 segment cranial to UIV has been transected, and third group (faset group-FG) was applied facet joint excision. 25 N, 50 N, 100 N, 150 N and 200 N forces applied at frequency of 5 Hertz as 100 cycles axial to the samples. Then, 250 N, 275 N and 300 N forces applied static axially. Interspinosus distance, kyphosis angle and discus heights was measured in radiological evaluation. Abnormal PJK was defined by a proximal junctional angle greater than 100 and at least 100 greater than the corresponding preoperative measurement. Results: In CG group, average interspinosus distancewas 6,6 +/- 1.54 mm and kyphosis angle was 2,2 +/- 0.46 degrees before biomechanical testing, and they were measured as 9,4 +/- 1.21 mm and 3,3 +/- 0.44 degrees respectively after forces applied to samples. In SG group, average interspinosus distance was 6,2 +/- 1.72 mm and kyphosis angle was 2,7 +/- 1.01 degrees before experiment, and they were measured as 20,8 +/- 5.66 mm and 15,1 +/- 2.34 degrees respectively after forces applied to samples. In FG group, average interspinosus distancewas 4,8 +/- 1.15 mm and kyphosis angle was -1 +/- 4.14 degrees before experiment, and they were measured as 11,1 +/- 1:96 mm and 11 +/- 2.87 degrees respectively after forces applied to samples. In comparison to group CG, statistically significant junctional kyphosis was seen on both FG and SG group after statistical analysis. (p < 0.05). PJK was seen statistically significant more on SG group than FG group. (p < 0.05). Not any statistically significant difference was seen on measurement of disk distances among three groups. (p > 0.05) Conclusions: Protecting interspinosus ligament complex and facet joint unity during posterior surgical treatment for spine deformation is vital to prevent PJK development. Based on our literature review, this is the first biomechanical study that reveals interspinosus ligament complex are more effective on preventing PJK development than facet joints. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.en_US
dc.identifier.citationKorkmaz, M., Akgul, T., Sariyilmaz, K., Ozkunt, O., Dikici, F., & Yazicioglu, O. (2019). Effectiveness of posterior structures in the development of proximal junctional kyphosis following posterior instrumentation: A biomechanical study in a sheep spine model. Acta orthopaedica et traumatologica turcica, 53(5), 385-389.en_US
dc.identifier.doi10.1016/j.aott.2019.01.003en_US
dc.identifier.endpage389en_US
dc.identifier.issn1017-995Xen_US
dc.identifier.issue5en_US
dc.identifier.pmid30711395en_US
dc.identifier.scopus2-s2.0-85060718150en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage385en_US
dc.identifier.trdizinid331646en_US
dc.identifier.urihttps://doi.org/10.1016/j.aott.2019.01.003
dc.identifier.urihttps://hdl.handle.net/20.500.12713/558
dc.identifier.volume53en_US
dc.identifier.wosWOS:000495621200014en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorÖzkunt, Okanen_US
dc.language.isoenen_US
dc.publisherTurkish Assoc Orthopaedics Traumatologyen_US
dc.relation.ispartofActa Orthopaedica Et Traumatologica Turcicaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectProximal Junctional Kyphosisen_US
dc.subjectJunctional Disordersen_US
dc.subjectBiomechanicen_US
dc.subjectPjken_US
dc.subjectAdolescent Idiopathic Scoliosisen_US
dc.subjectScheuermann Kyphosisen_US
dc.titleEffectiveness of posterior structures in the development of proximal junctional kyphosis following posterior instrumentation: A biomechanical study in a sheep spine modelen_US
dc.typeArticleen_US

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