Factors affecting postoperative activities of daily living in patients with osteoporotic vertebral collapse with neurological deficits

Verfasser / Beitragende:
[Masafumi Kashii, Ryoji Yamazaki, Tomoya Yamashita, Shinya Okuda, Takahito Fujimori, Yukitaka Nagamoto, Yuichi Tamura, Takenori Oda, Tetsuo Ohwada, Motoki Iwasaki, Hideki Yoshikawa]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Bone and Mineral Metabolism, 33/4(2015-07-01), 422-431
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00774-014-0604-8  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00774-014-0604-8 
245 0 0 |a Factors affecting postoperative activities of daily living in patients with osteoporotic vertebral collapse with neurological deficits  |h [Elektronische Daten]  |c [Masafumi Kashii, Ryoji Yamazaki, Tomoya Yamashita, Shinya Okuda, Takahito Fujimori, Yukitaka Nagamoto, Yuichi Tamura, Takenori Oda, Tetsuo Ohwada, Motoki Iwasaki, Hideki Yoshikawa] 
520 3 |a Surgical treatment of osteoporotic vertebral collapse (OVC) with neurological deficits presents significant clinical challenges because some patients have fragile bones and often have medical comorbidities, which affect the severity of osteoporosis. We hypothesized that clinical results of surgery in these patients depend on the extent of medical comorbidities that induce secondary osteoporosis. The aim of this study is to examine the effects of medical history and comorbidities on surgical outcomes for these patients, along with the factors that predict postoperative function in activities of daily living (ADL). We retrospectively reviewed data for 88 patients with OVC and neurological deficits who underwent surgery. We assessed clinical results regarding neurological deficits and function in ADL. The presence or absence of comorbidities responsible for secondary osteoporosis and treatments or medical events that affect bone metabolism were examined. We performed statistical analysis to examine prognostic factors for postoperative function in ADL. Of 88 patients, the distributions of comorbidities, treatment, and events in medical history were as follows: hypertension, 57 patients (64.8%); chronic kidney disease (CKD) stage 3 or 4, 32 (36.4%); diabetes mellitus, 16 (18.2%); liver dysfunction, 11 (12.5%); cardiovascular disease, 10 (11.4%); rheumatoid arthritis, 9 (10.2%); and glucocorticoid intake, 8 (9.1%). Twenty-five patients (28.4%) represented poor postoperative ADL (chair-bound or bed-bound), and 11 of 25 patients with poor postoperative ADL represented full neurological recovery. Multivariate analysis revealed decreased estimated glomerular filtration rate (odds ratio 0.96; 95% confidence interval 0.93-0.99; p=0.005) and a high serum alkaline phosphatase (ALP) level (odds ratio 1.01; 95% CI 1.00-1.02; p=0.01) were strong predictive factors for poor postoperative function in ADL. The majority of patients with poor postoperative function in ADL had advanced CKD with a disorder of bone metabolism as well as bone fragility. 
540 |a The Japanese Society for Bone and Mineral Research and Springer Japan, 2014 
690 7 |a Osteoporotic vertebral collapse  |2 nationallicence 
690 7 |a Neurological impairment  |2 nationallicence 
690 7 |a Activities of daily living  |2 nationallicence 
690 7 |a Alkaline phosphatase  |2 nationallicence 
690 7 |a Chronic kidney disease  |2 nationallicence 
700 1 |a Kashii  |D Masafumi  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
700 1 |a Yamazaki  |D Ryoji  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
700 1 |a Yamashita  |D Tomoya  |u Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan  |4 aut 
700 1 |a Okuda  |D Shinya  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
700 1 |a Fujimori  |D Takahito  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
700 1 |a Nagamoto  |D Yukitaka  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
700 1 |a Tamura  |D Yuichi  |u Department of Orthopedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, 560-8565, Toyonaka, Osaka, Japan  |4 aut 
700 1 |a Oda  |D Takenori  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
700 1 |a Ohwada  |D Tetsuo  |u Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan  |4 aut 
700 1 |a Iwasaki  |D Motoki  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
700 1 |a Yoshikawa  |D Hideki  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
773 0 |t Journal of Bone and Mineral Metabolism  |d Springer Japan  |g 33/4(2015-07-01), 422-431  |x 0914-8779  |q 33:4<422  |1 2015  |2 33  |o 774 
856 4 0 |u https://doi.org/10.1007/s00774-014-0604-8  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00774-014-0604-8  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kashii  |D Masafumi  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yamazaki  |D Ryoji  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yamashita  |D Tomoya  |u Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Okuda  |D Shinya  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fujimori  |D Takahito  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nagamoto  |D Yukitaka  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tamura  |D Yuichi  |u Department of Orthopedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, 560-8565, Toyonaka, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Oda  |D Takenori  |u Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ohwada  |D Tetsuo  |u Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Iwasaki  |D Motoki  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yoshikawa  |D Hideki  |u Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Bone and Mineral Metabolism  |d Springer Japan  |g 33/4(2015-07-01), 422-431  |x 0914-8779  |q 33:4<422  |1 2015  |2 33  |o 774