Proximal Junctional Kyphosis

2021 ◽  
pp. 100902
Author(s):  
Richard D. Lander ◽  
Emmanuel N. Menga
Keyword(s):  
Proximal Junctional Kyphosis ◽  
Junctional Kyphosis

State of the art: proximal junctional kyphosis—diagnosis, management and prevention

2021 ◽  
Author(s):  
Zeeshan M. Sardar ◽  
◽  
Yongjung Kim ◽  
Virginie Lafage ◽  
Frank Rand ◽  
...  
Keyword(s):  
State Of The Art ◽  
Proximal Junctional Kyphosis ◽  
Junctional Kyphosis

The utility of supine radiographs in the assessment of thoracic flexibility and risk of proximal junctional kyphosis

2021 ◽  
pp. 1-7
Author(s):  
Francis Lovecchio ◽  
Renaud Lafage ◽  
Jonathan Charles Elysee ◽  
Alex Huang ◽  
Bryan Ang ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Lumbar Lordosis ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Vertical Axis ◽  
Control Analysis ◽  
Proximal Junctional Kyphosis ◽  
Sagittal Vertical Axis ◽  
Significant Difference ◽  
Junctional Kyphosis

OBJECTIVE Supine radiographs have successfully been used for preoperative planning of lumbar deformity corrections. However, they have not been used to assess thoracic flexibility, which has recently garnered attention as a potential contributor to proximal junctional kyphosis (PJK). The purpose of this study was to compare supine to standing radiographs to assess thoracic flexibility and to determine whether thoracic flexibility is associated with PJK. METHODS A retrospective study was conducted of a single-institution database of patients with adult spinal deformity (ASD). Sagittal alignment parameters were compared between standing and supine and between pre- and postoperative radiographs. Thoracic flexibility was determined as the change between preoperative standing thoracic kyphosis (TK) and preoperative supine TK, and these changes were measured over the overall thoracic spine and the fused portion of the thoracic spine (i.e., TK fused). A case-control analysis was performed to compare thoracic flexibility between patients with PJK and those without (no PJK). The cohort was also stratified into three groups based on thoracic flexibility: kyphotic change (increased TK), lordotic change (decreased TK), and no change. The PJK rate was compared between the cohorts. RESULTS A total of 101 patients (mean 63 years old, 82.2% female, mean BMI 27.4 kg/m2) were included. Preoperative Scoliosis Research Society–Schwab ASD classification showed moderate preoperative deformity (pelvic tilt 27.7% [score ++]; pelvic incidence–lumbar lordosis mismatch 44.6% [score ++]; sagittal vertical axis 42.6% [score ++]). Postoperatively, the average offset from age-adjusted alignment goals demonstrated slight overcorrection in the study sample (−8.5° ± 15.6° pelvic incidence–lumbar lordosis mismatch, −29.2 ± 53.1 mm sagittal vertical axis, −5.4 ± 10.8 pelvic tilt, and −7.6 ± 11.7 T1 pelvic angle). TK decreased between standing and supine radiographs and increased postoperatively (TK fused: −25.3° vs −19.6° vs −29.9°; all p < 0.001). The overall rate of radiographic PJK was 23.8%. Comparisons between PJK and no PJK demonstrated that offsets from age-adjusted alignment goals were similar (p > 0.05 for all). There was a significant difference in the PJK rate when stratified by thoracic flexibility cohorts (kyphotic: 0.0% vs no change: 18.4% vs lordotic: 35.0%; p = 0.049). Logistic regression revealed thoracic flexibility (p = 0.045) as the only independent correlate of PJK. CONCLUSIONS Half of patients with ASD experienced significant changes in TK during supine positioning, a quality that may influence surgical strategy. Increased thoracic flexibility is associated with PJK, possibly secondary to fusing the patient’s spine in a flattened position intraoperatively.

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

Proximal Junctional Kyphosis in Adult Spinal Deformity After Segmental Posterior Spinal Instrumentation and Fusion

Spine ◽  
2008 ◽  
Vol 33 (20) ◽  
pp. 2179-2184 ◽  
Author(s):  
Yongjung J. Kim ◽  
Keith H. Bridwell ◽  
Lawrence G. Lenke ◽  
Chris R. Glattes ◽  
Seungchul Rhim ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinal Instrumentation ◽  
Proximal Junctional Kyphosis ◽  
Junctional Kyphosis
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