The impact of segmental spinal alignment on the development of proximal junctional kyphosis after instrumented posterior spinal fusions for idiopathic scoliosis

2021 ◽  
Author(s):  
Scott J. Luhmann ◽  
Justin Roth ◽  
Danielle DeFreitas ◽  
Sekinat McCormick
Keyword(s):  
Idiopathic Scoliosis ◽  
Proximal Junctional Kyphosis ◽  
Spinal Alignment ◽  
Spinal Fusions ◽  
The Impact ◽  
Junctional Kyphosis

scholarly journals Incidence of Proximal Junctional Kyphosis With Pedicle Screws at Upper Instrumented Vertebrae in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

2020 ◽  
pp. 219256822093510
Author(s):  
Yoji Ogura ◽  
Steven D. Glassman ◽  
Daniel Sucato ◽  
M. Timothy Hresko ◽  
Leah Y. Carreon
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Pedicle Screw ◽  
Standard Procedure ◽  
Pedicle Screws ◽  
Posterior Spinal Fusion ◽  
Proximal Junctional Kyphosis ◽  
The Impact ◽  
Junctional Kyphosis

Study Design: Longitudinal cohort. Objectives: Posterior spinal fusion (PSF) using all-pedicle screw constructs has become the standard procedure in the treatment of adolescent idiopathic scoliosis (AIS). However, there have been several reports that all-pedicle screw constructs or the use of pedicle screws at the upper instrumented vertebrae (UIV) increases the incidence of proximal junctional kyphosis (PJK). We aimed to evaluate the impact of instrumentation type on the incidence of PJK following PSF for AIS. Methods: We performed a stratified random sampling from 3654 patients enrolled in a multicenter database of surgically treated AIS to obtain a representative sample from all Lenke types. Patients were then allocated into 3 groups based on the instrumentation type: all-pedicle screw (PS), hook at UIV with pedicle screws distally (HT), and hybrid constructs (HB). We measured proximal junctional angle (PJA) and defined PJK as PJA ≥ 10° and PJA progression of >10° at the final follow-up. Results: Fifteen (4.3%) of 345 cases had PJK. PJK was significantly more common in PS (11%) compared with HB (1%) and HT (0%) ( P < .001). PJK patients were similar to non-PJK patients regarding age, sex, curve type, UIV, and preoperative coronal Cobb angle. Thoracic kyphosis was significantly higher in the PJK group before surgery. Patients who developed PJK had a statistically significantly larger negative sagittal balance compared with the non-PJK group. Conclusion: The incidence of PJK was 4.3% and was more common in all-pedicle screw constructs. Using hooks at UIV might be a treatment strategy to limit PJK.

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
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