P102. Determining the impact of proximal junctional kyphosis on cost utility in adult spinal deformity patients

2021 ◽  
Vol 21 (9) ◽  
pp. S190
Author(s):  
Peter G. Passias ◽  
Oscar Krol ◽  
Lara Passfall ◽  
Nicholas Kummer ◽  
Katherine E. Pierce ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Cost Utility ◽  
Proximal Junctional Kyphosis ◽  
The Impact ◽  
Junctional Kyphosis

scholarly journals The Impact of Global Alignment and Proportion Score and Bracing on Proximal Junctional Kyphosis in Adult Spinal Deformity

2021 ◽  
pp. 219256822110018
Author(s):  
Elizabeth L. Lord ◽  
Ethan Ayres ◽  
Dainn Woo ◽  
Dennis Vasquez-Montes ◽  
Yesha Parekh ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Chart Review ◽  
Adult Spinal Deformity ◽  
Retrospective Chart Review ◽  
Global Alignment ◽  
X Rays ◽  
Proximal Junctional Kyphosis ◽  
Upper Instrumented Vertebra ◽  
The Impact ◽  
Junctional Kyphosis

Study Design: Retrospective chart review. Objective: The goal of this study is to examine the relationship between global alignment and proportion (GAP) score and postoperative orthoses with likelihood of developing proximal junctional kyphosis (PJK). Methods: Patients who underwent thoracic or lumbar fusions of ≥4 levels for adult spinal deformity (ASD) with 1-year post-operative alignment x-rays were included. Chart review was conducted to determine spinopelvic alignment parameters, PJK, and reoperation. Results: A total of 81 patients were included; baseline and 1-year postoperative alignment did not differ between patients with and without PJK. There was no PJK in 53.1%, 29.6% had PJK from 10-20°, and 17.3% had severe PJK over 20° (sPJK). At baseline, 80% of patients had severely disproportioned GAP, 13.75% moderate, 6.25% proportioned. GAP improved across the population, but improved GAP was not associated with sPJK. Greater correction of the upper instrumented vertebra to pelvic angle (UIV-PA) was associated with a larger PJK angle (PJKA) change (R = -0.28) as was the 1 year T1-upper instrumented vertebra (T1-UIV) angle (R = 0.30), both P < .05. GAP change was not correlated with PJKA change. Postoperative orthoses were used in 46% of patients and did not impact sPJK. Conclusions: There was no correlation between PJK and GAP or change in GAP. Greater correction of UIV-PA and larger postop T1-UIV was associated with greater PJKA change; suggesting that the greater alignment correction led to greater likelihood of failure. Postoperative orthoses had no impact on PJK.

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

Proximal junctional kyphosis in adult spinal deformity: a novel predictive index

2018 ◽  
Vol 27 (9) ◽  
pp. 2303-2311 ◽  
Author(s):  
Jian Zhao ◽  
Mingyuan Yang ◽  
Yilin Yang ◽  
Xin Yin ◽  
Changwei Yang ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Proximal Junctional Kyphosis ◽  
Predictive Index ◽  
Junctional Kyphosis

scholarly journals Posterior Ligamentous Reinforcement of the Upper Instrumented Vertebrae +1 Does Not Decrease Proximal Junctional Kyphosis in Adult Spinal Deformity

2019 ◽  
Vol 10 (6) ◽  
pp. 692-699
Author(s):  
Sravisht Iyer ◽  
Francis Lovecchio ◽  
Jonathan Charles Elysée ◽  
Renaud Lafage ◽  
Michael Steinhaus ◽  
...  
Keyword(s):  
Cohort Study ◽  
Spinal Deformity ◽  
Soft Tissues ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Proximal Junctional Kyphosis ◽  
Propensity Matching ◽  
Surgical Data ◽  
Junctional Kyphosis

Study Design: Retrospective cohort study. Objectives: Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Biomechanical and clinical studies suggest that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK. The purpose of this study was to evaluate the effect of PLS augmentation on the rate of PJK at 1 year. Methods: A retrospective single-surgeon cohort study was performed of 108 adult spinal deformity patients who underwent 5 level fusions to the pelvis. Patients were divided into 2 groups: PLS+ patients had reconstruction of the PLS between upper instrumented vertebrae +1 (UIV+1) and UIV−1 with a surgical nylon tape while PLS− patients did not. Demographics, surgical data, and sagittal alignment parameters were compared between the cohorts. The primary outcome of interest was the development of PJK at final follow-up. A subgroup propensity match and logistic regression model were utilized to control for differences in the cohorts. Results: A total of 108 patients met final criteria, 31 patients (28.7%) were PLS+. There were no differences with regard to preoperative or final sagittal alignment parameters, number of levels fused, rates of 3-column osteotomies, and body mass index ( P > .05), though the PLS+ cohort was older and had larger initial sagittal corrections ( P < .05). The rates of PJK for PLS+ (27.3%) and PLS− (28.6%) were similar ( P = .827). After controlling for sagittal correction via propensity matching, PLS+ had no impact on PJK (29% vs 38.7%, P = .367). In our multivariate analysis, only increased sagittal malalignment and failure to restore sagittal balance were retained as significant predictors of PJK. Conclusion: Even after controlling for extent of correction and preoperative sagittal alignment, PLS reinforcement at UIV+1 using a hand-tensioned nylon tape does not reduce the incidence of PJK at 1 year.

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