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Medicina
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Recent Updates in Geriatric Spine Surgery
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Recent Updates in Geriatric Spine Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 4351

Special Issue Editors

Dr. Sang-Il Kim

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
Interests: spinal deformity; cervical spine disease; orthopedic
Dr. Young Yul Kim

E-Mail Website
Guest Editor
Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
Interests: cervical spine; biomaterial; minimally invasive surgery; osteoporosis

Special Issue Information

Dear Colleagues,

As human life expectancy is continuously increasing, the medical need to treat spine problems in the elderly population is also increasing. However, it is believed that spine surgery in elderly patients can cause more frequent complications than in younger patients. Also, elderly patients often suffer from several problems, such as poor bone quality or comorbidities, hindering favorable surgical outcomes. To improve surgical outcomes and reduce complications, these problems should be considered and assessed preoperatively and managed peri-/postoperatively.

Recently, other potential risk factors have emerged, including sarcopenia, frailty, or malnutrition, as well as traditional risk factors, which have been studied in geriatric fields. Therefore, preoperative optimization cannot be overemphasized. Also, minimally invasive spine surgery is attracting much attention in surgical fields.

This Special Issue, entitled “Recent Updates in Geriatric Spine Surgery”, aims to share research on and recent experiences regarding geriatric spine surgery.

We invite any papers related to geriatric spine surgery, including case series, retrospective or prospective clinical studies, systematic reviews, and meta-analyses. Valuable editorials and expert review articles are also welcome.

Dr. Sang-Il Kim 
Dr. Young Yul Kim
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • age
  • geriatric
  • spine surgery
  • outcome
  • management
  • complication
  • degenerative
  • minimally invasive surgery
  • preoperative optimization

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Published Papers (2 papers)

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Research

12 pages, 2948 KiB  
Article
Analysis of Risk Factors Associated with Proximal Junctional Kyphosis Following Long Instrumented Fusion from L1 to Sacrum: Age Itself Does Not Independently Increase the Risk
by Joonghyun Ahn, Young-Hoon Kim, Yong-Chan Kim, Ki-Tack Kim, Sung-Min Kim, Jun Bum Park and Kee-Yong Ha
Medicina 2024, 60(9), 1441; https://doi.org/10.3390/medicina60091441 - 3 Sep 2024
Viewed by 1848
Abstract
Background and Objectives: This study is a retrospective analysis aimed at understanding the incidence and risk factors of proximal junctional kyphosis (PJK) following long-instrumented spinal fusion from L1 to the sacrum in patients with mild to moderate sagittal imbalance. Materials and Methods: It [...] Read more.
Background and Objectives: This study is a retrospective analysis aimed at understanding the incidence and risk factors of proximal junctional kyphosis (PJK) following long-instrumented spinal fusion from L1 to the sacrum in patients with mild to moderate sagittal imbalance. Materials and Methods: It recruited consecutive patients undergoing instrumented fusion from L1 to the sacrum for degenerative lumbar disease between June 2006 and November 2019 in a single institution. The patients’ preoperative clinical data, muscle status at T12-L1 on magnetic resonance images, and sagittal spinopelvic parameters were analyzed. Univariate analysis was used to compare clinical and radiographic data between PJK and non-PJK patients. Logistic regression analysis was used to investigate the independent risk factors for PJK. Results: A total of 56 patients were included in this study. The mean age at surgery was 67.3 years and mean follow-up period was 37.3 months. In total, 10 were male and 46 were female. PJK developed in 23 (41.1%) out of 56; of these patients, 20 (87.0%) developed PJK within 1 year postoperatively. In the univariate analysis between PJK and non-PJK patients, the PJK group showed more frequent osteoporosis, lower body mass index, smaller cross-sectional area (CSA) and more fat infiltration (FI) in erector spinae muscle at T12-L1 and larger preoperative TLK and PT with statistical significance (p < 0.05). In the logistic regression analysis, severe (>50%) FI in erector spinae muscle (OR = 43.60, CI 4.10–463.06, R2N = 0.730, p = 0.002) and osteoporosis (OR = 20.49, CI 1.58–264.99, R2N = 0.730, p = 0.021) were statistically significant. Conclusions: Preexisting severe (>50%) fat infiltration in the erector spinae muscle and osteoporosis were independent risk factors associated with PJK following instrumented fusion from L1 to the sacrum, but age was not a risk factor. Full article
(This article belongs to the Special Issue Recent Updates in Geriatric Spine Surgery)
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8 pages, 269 KiB  
Article
The Effects of Longer Use of Teriparatide on Clinical and Radiographic Outcomes after Spinal Fusion in Geriatric Patients
by Young-Hoon Kim, Kee-Yong Ha, Hyun W. Bae, Hyung-Youl Park, Young-Il Ko, Myung-Sup Ko and Sang-Il Kim
Medicina 2024, 60(6), 946; https://doi.org/10.3390/medicina60060946 - 6 Jun 2024
Cited by 1 | Viewed by 2030
Abstract
Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote [...] Read more.
Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote the spine fusion process and decrease mechanical complications. However, there was no consensus regarding optimal treatment duration. The purpose of this study was to compare surgical outcomes between short-duration and long-duration teriparatide treatment after lumbar fusion surgery in elderly patients. Materials and Methods: All consecutive patients older than 60 years who underwent 1-level lumbar fusion surgery for degenerative diseases between January 2015 and December 2019 were retrospectively reviewed. Based on the duration of teriparatide treatment (daily subcutaneous injection of 20 µg teriparatide), patients were subdivided into two groups: a short-duration (SD) group (<6 months) and a long-duration (LD) group (≥6 months). Mechanical complications, such as screw loosening, cage subsidence, and adjacent vertebral fractures, were investigated. Postoperative 1-year union rate was also evaluated on computed tomography. Clinical outcomes were recorded using visual analog scale (VAS) and Oswestry Disability Index (ODI). Between-group differences for these radiographic and clinical outcomes were analyzed. Results: Ninety-one patients were reviewed in this study, including sixty patients in the SD group and thirty-one patients in the LD group. Their mean age was 72.3 ± 6.2 years, and 79 patients were female. Mean T-score was −3.3 ± 0.8. Cage subsidence (6.7% vs. 3.2%), screw loosening (28.3% vs. 35.5%), and adjacent vertebral fracture (6.7% vs. 9.7%) were not significantly different between the SD and LD groups. Union rate at 1-year postoperative was 65.0% in the SD group and 87.1% in the LD group (p = 0.028). Both groups showed improvement in VAS and ODI after surgery. However, the differences of VAS from preoperative to 6 months and 1 year postoperative were significantly higher in the LD group. Conclusions: Longer teriparatide treatment after lumbar fusion surgery resulted in a higher union rate at 1-year postoperative than the shorter treatment. Also, it could be more beneficial for clinical outcomes. Full article
(This article belongs to the Special Issue Recent Updates in Geriatric Spine Surgery)
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