caa a22 4500 60546331X CHVBK 20210128100252.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00774-014-0604-8 doi (NATIONALLICENCE)springer-10.1007/s00774-014-0604-8 Factors affecting postoperative activities of daily living in patients with osteoporotic vertebral collapse with neurological deficits [Elektronische Daten] [Masafumi Kashii, Ryoji Yamazaki, Tomoya Yamashita, Shinya Okuda, Takahito Fujimori, Yukitaka Nagamoto, Yuichi Tamura, Takenori Oda, Tetsuo Ohwada, Motoki Iwasaki, Hideki Yoshikawa] 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. The Japanese Society for Bone and Mineral Research and Springer Japan, 2014 Osteoporotic vertebral collapse nationallicence Neurological impairment nationallicence Activities of daily living nationallicence Alkaline phosphatase nationallicence Chronic kidney disease nationallicence Kashii Masafumi Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Yamazaki Ryoji Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut Yamashita Tomoya Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan aut Okuda Shinya Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut Fujimori Takahito Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Nagamoto Yukitaka Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Tamura Yuichi Department of Orthopedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, 560-8565, Toyonaka, Osaka, Japan aut Oda Takenori Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut Ohwada Tetsuo Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan aut Iwasaki Motoki Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Yoshikawa Hideki Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut Journal of Bone and Mineral Metabolism Springer Japan 33/4(2015-07-01), 422-431 0914-8779 33:4<422 2015 33 774 https://doi.org/10.1007/s00774-014-0604-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00774-014-0604-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kashii Masafumi Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Yamazaki Ryoji Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut NATIONALLICENCE 700 1- Yamashita Tomoya Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan aut NATIONALLICENCE 700 1- Okuda Shinya Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut NATIONALLICENCE 700 1- Fujimori Takahito Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nagamoto Yukitaka Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Tamura Yuichi Department of Orthopedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, 560-8565, Toyonaka, Osaka, Japan aut NATIONALLICENCE 700 1- Oda Takenori Department of Orthopedic Surgery, Osaka Rousai Hospital, 1179-3 Nagasonecho, 591-8025, Sakai, Osaka, Japan aut NATIONALLICENCE 700 1- Ohwada Tetsuo Department of Orthopedic Surgery, Kansai Rousai Hospital, 3-1-69 Inabasou, 660-8511, Amagasaki, Hyogo, Japan aut NATIONALLICENCE 700 1- Iwasaki Motoki Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Yoshikawa Hideki Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 773 0- Journal of Bone and Mineral Metabolism Springer Japan 33/4(2015-07-01), 422-431 0914-8779 33:4<422 2015 33 774