A Patient-specific Approach to Alignment and Proximal Junctional Kyphosis Risk Assessment in Adult Spinal Deformity Surgery

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jeffrey M. Hills ◽  
Benjamin M. Weisenthal ◽  
John P. Wanner ◽  
Rishabh Gupta ◽  
Anthony Steinle ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Patient Specific ◽  
Proximal Junctional Kyphosis ◽  
Specific Approach ◽  
Spinal Deformity Surgery ◽  
Junctional Kyphosis

scholarly journals Proximal Junctional Kyphosis and Proximal Junctional Failure Following Adult Spinal Deformity Surgery

2017 ◽  
Vol 14 (4) ◽  
pp. 126-132 ◽  
Author(s):  
Seung-Jae Hyun ◽  
Byoung Hun Lee ◽  
Jong-Hwa Park ◽  
Ki-Jeong Kim ◽  
Tae-Ahn Jahng ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Proximal Junctional Kyphosis ◽  
Spinal Deformity Surgery ◽  
Proximal Junctional Failure ◽  
Junctional Kyphosis

scholarly journals Risk Factor Analysis for Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery: A New Simple Scoring System to Identify High-Risk Patients

2019 ◽  
Vol 10 (7) ◽  
pp. 863-870
Author(s):  
Renaud Lafage ◽  
George Beyer ◽  
Frank Schwab ◽  
Eric Klineberg ◽  
Douglas Burton ◽  
...  
Keyword(s):  
Risk Factor ◽  
Thoracic Spine ◽  
Spinal Deformity ◽  
Scoring System ◽  
Adult Spinal Deformity ◽  
Proximal Junctional Kyphosis ◽  
Point Score ◽  
Spinal Deformity Surgery ◽  
Upper Thoracic ◽  
Junctional Kyphosis

Study Design: Retrospective cohort study. Objective: Develop a simple scoring system to estimate proximal junctional kyphosis (PJK) risk. Methods: A total of 417 adult spinal deformity (ASD) patients (80% females, 57.8 years) with 2-year follow-up were included. PJK was defined as a >10° kyphotic angle between the upper-most instrumented vertebra (UIV) and the vertebrae 2 levels above the UIV (UIV+2). Based on a previous literature review, the following point score was attributed to parameters likely to impact PJK development: age >55 years (1 point), fusion to S1/ilium (1 point), UIV in the upper thoracic spine (UIV-UT: 1 point), UIV in the lower thoracic region (UIV-LT: 2 points), flattening of the thoracic kyphosis (TK) relative to the lumbar lordosis (LL; ie, ▵LL − ▵TK) greater than 10° (1 point). Results: At 2 years, the overall PJK rate was 43%. The odds ratios for each risk factor were the following: age >55 years (2.52), fusion to S1/ilium (5.17), UIV-UT (6.63), UIV-LT (8.24), and ▵LL − ▵TK >10° (1.59). Analysis by risk factor revealed a significant impact on PJK (no PJK vs PJK): age >55 years (28% vs 51%, P < .001), LIV S1/ilium (16.3% vs 51.4%, P < .001), UIV in lower thoracic spine (12.0% vs 38.7% vs 52.9%, P < .001), and a >10° surgical reduction in TK relative to LL increase (40.0% vs 51.5%, P < .001). The PJK rate by point score was as follows: 1 = 17%, 2 = 29%, 3 = 40%, 4 = 53%, and 5 = 69%. Conclusion: A pragmatic scoring system was developed that is tied to the increasing risk of PJK. These findings are helpful for surgical planning and preoperative counseling.

The Uppermost Instrumented Vertebra Mechanical Loading Correlates with the Magnitude of Proximal Junctional Kyphosis in Adult Spinal Deformity Surgery

2016 ◽  
Vol 16 (10) ◽  
pp. S161-S162 ◽  
Author(s):  
Jonathan Elysee ◽  
Renaud Lafage ◽  
Breton Line ◽  
Frank J. Schwab ◽  
Justin S. Smith ◽  
...  
Keyword(s):  
Mechanical Loading ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Proximal Junctional Kyphosis ◽  
Spinal Deformity Surgery ◽  
Junctional Kyphosis
Sign in / Sign up

Export Citation Format

Share Document