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Proximal junction kyphosis

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https://www.readbyqxmd.com/read/28522402/prophylactic-vertebral-cement-augmentation-at-the-uppermost-instrumented-vertebra-and-rostral-adjacent-vertebra-for-the-prevention-of-proximal-junctional-kyphosis-and-failure-following-long-segment-fusion-for-adult-spinal-deformity
#1
George M Ghobrial, Daniel G Eichberg, John Paul G Kolcun, Karthik Madhavan, Nathan H Lebwohl, Barth A Green, Joseph P Gjolaj
BACKGROUND CONTEXT: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are common problems after long segment (>5 levels) thoracolumbar instrumented fusions in the treatment of adult spinal deformity (ASD). No specific surgical strategy has definitively been shown to lower the risk of PJK as the result of a multifactorial etiology. PURPOSE: To assess the incidence of PJK and PJF in patients treated with prophylactic polymethylmethacrylate(PMMA) cement augmentation at the uppermost instrumented vertebrae(UIV) and rostral adjacent vertebrae(UIV+1)...
May 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28506822/the-effect-of-prophylactic-vertebroplasty-on-the-incidence-of-proximal-junctional-kyphosis-and-proximal-junctional-failure-following-posterior-spinal-fusion-in-adult-spinal-deformity-a-5-year-follow-up-study
#2
Tina Raman, Emily Miller, Christopher T Martin, Khaled Kebaish
BACKGROUND CONTEXT: The incidence of proximal junctional kyphosis (PJK) ranges from 5-46% following adult spinal deformity (ASD) surgery. Approximately 66-76% of PJK occurs within 3 months of surgery. A subset of these patients, reportedly 26-47%, develop proximal junctional failure (PJF) within 6 months postoperatively. To date, there are no studies evaluating the impact of prophylactic vertebroplasty on PJK/PJF incidence at long term follow-up. PURPOSE: The purpose of this study is to evaluate the long term radiographic and clinical outcomes, and incidence of PJK and PJF, after prophylactic vertebroplasty for long segment thoracolumbar posterior spinal fusion...
May 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28449961/risk-factors-of-proximal-junctional-kyphosis-in-adolescent-idiopathic-scoliosis-the-pelvis-and-other-considerations
#3
Baron S Lonner, Yuan Ren, Peter O Newton, Suken A Shah, Amer F Samdani, Harry L Shufflebarger, Jahangir Asghar, Paul Sponseller, Randal R Betz, Burt Yaszay
STUDY DESIGN: Prospective multicenter database study. OBJECTIVES: To assess the incidence of proximal junctional kyphosis (PJK) in operative adolescent idiopathic scoliosis (AIS) using contemporary surgical techniques and to identify risk factors for PJK. SUMMARY OF BACKGROUND DATA: The incidence of PJK has been reported as high as 46% in AIS. Factors associated with PJK have been incompletely explored. METHODS: Prospectively enrolled 851 AIS patients (2000-2011, 78...
May 2017: Spine Deformity
https://www.readbyqxmd.com/read/28441308/factors-associated-with-the-development-of-and-revision-for-proximal-junctional-kyphosis-in-440-consecutive-adult-spinal-deformity-patients
#4
Fred H Nicholls, Junseok Bae, Alexander A Theologis, Murat S Eksi, Christopher P Ames, Sigurd H Berven, Shane Burch, Bobby K Tay, Vedat Deviren
STUDY DESIGN: Retrospective review of prospectively collected data OBJECTIVE.: The aim of this study was to examine which radiographic parameters and surgical strategies are most closely associated with proximal junctional kyphosis (PJK) after adult spinal deformity (ASD) surgery, the need for revision surgery for PJK, and whether these differ based on the upper instrumented vertebra (UIV). SUMMARY OF BACKGROUND DATA: Multiple parameters are considered when planning correction of ASD...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28441306/orientation-of-the-upper-most-instrumented-segment-influences-proximal-junctional-disease-following-adult-spinal-deformity-surgery
#5
Renaud Lafage, Breton G Line, Sachin Gupta, Barthelemy Liabaud, Frank Schwab, Justin S Smith, Jeffrey L Gum, Christopher P Ames, Richard Hostin, Gregory M Mundis, Han Jo Kim, Shay Bess, Eric Klineberg, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective database. OBJECTIVE: To define the role of sagittal orientation of the construct at the upper instrumented levels in the development of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA: PJK following ASD surgery remains challenging. The final alignment of the upper instrumented vertebral segments has been proposed as a risk factor for PJK, but has not been fully investigated...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28437340/proximal-junctional-kyphosis-following-posterior-hemivertebra-resection-and-short-fusion-in-children-younger-than-10-years
#6
Yingsong Wang, Noriaki Kawakami, Taichi Tsuji, Tetsuya Ohara, Yoshitaka Suzuki, Toshiki Saito, Ayato Nohara, Ryoji Tauchi, Kazuki Kawakami
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate whether proximal junctional kyphosis (PJK) or obvious proximal junctional angle (PJA) changes in the sagittal plane develops following short fusion in children younger than 10 years of age with congenital scoliosis, and to investigate the possible risk factors. SUMMARY OF BACKGROUND DATA: PJK following long spinal fusion in adolescents and adults is a serious postoperative complication...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28427980/comparative-study-between-cobalt-chrome-and-titanium-alloy-rods-for-multi-level-spinal-fusion-proximal-junctional-kyphosis-more-frequently-occurred-in-patients-having-cobalt-chrome-rods
#7
Sanghyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
BACKGROUND: The use of titanium alloy (Ti) rods is frequently associated with rod fracture following spinal fixation. To address this issue, cobalt chrome (CoCr) rods-which are advantageous due to their greater strength and resistance to fatigue relative to Ti rods-have been introduced. The purpose of the present study was to compare radiographic outcomes following the use of Ti versus CoCr rods in a matched cohort of patients undergoing posterior spinal fusion for treatment of spinal instability...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28373080/is-a-gradual-reduction-of-stiffness-on-top-of-posterior-instrumentation-possible-with-a-suitable-proximal-implant-a-biomechanical-study
#8
Tobias Lange, Werner Schmoelz, Georg Gosheger, Martin Eichinger, Christian H Heinrichs, Albert Schulze Bövingloh, Tobias L Schulte
BACKGROUND CONTEXT: Proximal junctional kyphosis (PJK) is a challenging complication after rigid posterior instrumentation (RI) of the spine. Several risk factors have been described in literature so far, including the rigidity of the cranial aspect of the implant. PURPOSE: The aim of this biomechanical study was to compare different proximal implants designed to gradually reduce the stiffness between the instrumented and non-instrumented spine. STUDY DESIGN/SETTING: This is a biomechanical study...
March 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28365496/optimum-pelvic-incidence-minus-lumbar-lordosis-value-after-operation-for-patients-with-adult-degenerative-scoliosis
#9
Xiang-Yao Sun, Xi-Nuo Zhang, Yong Hai
BACKGROUND CONTEXT: Schwab classification for adult degenerative scoliosis (ADS) concluded that health-related quality of life (HRQOL) was closely related to curve type and three sagittal modifiers. It was suggested that pelvic incidence minus lumbar lordosis value (PI-LL) should be corrected within -10°~+10°. However, recent studies also indicated that ideal clinical outcomes could also be achieved in patients without ideal PI-LL mentioned above. PURPOSE: This study evaluated the relation between the clinical outcomes and the pelvic incidence minus lumbar lordosis value (PI-LL) of Chinese patients with ADS who received long posterior internal fixation and fusion...
March 29, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28343332/posterior-elements-disruption-with-hybrid-constructs-in-ais-patients-is-there-an-impact-on-proximal-junctional-kyphosis
#10
S Ghailane, Sebastien Pesenti, E Peltier, E Choufani, B Blondel, J L Jouve
PURPOSE: Proximal junctional kyphosis (PJK) is a frequent proximal adjacent segment disease following spinal fusion in adolescent idiopathic scoliosis (AIS) and its rate has been estimated to 28% in the literature. The etiology is multifactorial, and risk factors associated with PJK are controversial. The aim of this study was to demonstrate that the disruption of muscular and bony tissue above the upper instrumented vertebra (UIV) during surgery does not increase the rate of PJK in patients undergoing posterior fusion for adolescent idiopathic scoliosis...
May 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28342920/which-is-the-more-appropriate-proximal-fusion-level-for-adult-lumbar-degenerative-flat-back
#11
Jeong-Hoon Choi, Jee-Soo Jang, Hyeun-Sung Kim, Il-Tae Jang
OBJECTIVE: To determine the optimal proximal fusion level after long instrumented fusion to the sacrum for lumbar degenerative flat back. METHODS: Data from 70 patients with lumbar degenerative flat back were reviewed retrospectively. Three groups were designated according to the upper instrumented vertebrae (UIV) : Group 1 (UIV = T10 or above), Group 2 (UIV = T11 to T12), and Group 3 (UIV = L1 or below). Preoperative and postoperative pelvic parameters, degree of correction, and prevalence of proximal junctional kyphosis (PJK) and its risk factors were evaluated...
March 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28315802/upper-thoracic-versus-lower-thoracic-as-site-of-upper-instrumented-vertebrae-for-long-fusion-surgery-in-adult-spinal-deformity-a-meta-analysis-of-proximal-junctional-kyphosis
#12
Ming Luo, Pu Wang, Wengang Wang, Mingkui Shen, Genzhong Xu, Lei Xia
OBJECTIVE: A meta-analysis was performed to compare incidence rates of radiographic and surgical proximal junctional kyphosis (PJK) between upper thoracic (UT) versus lower thoracic (LT) as site of upper-instrumented vertebrae (UIV) endpoints for long fusion surgery in adult spinal deformity (ASD). METHODS: The MEDLINE, Embase, and the Cochrane Library databases were searched for English-language articles that addressed the UT versus LT fixation strategies. The division of the UT and LT groups was based on UIV...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28291402/complication-rates-associated-with-3-column-osteotomy-in-82-adult-spinal-deformity-patients-retrospective-review-of-a-prospectively-collected-multicenter-consecutive-series-with-2-year-follow-up
#13
Justin S Smith, Christopher I Shaffrey, Eric Klineberg, Virginie Lafage, Frank Schwab, Renaud Lafage, Han Jo Kim, Richard Hostin, Gregory M Mundis, Munish Gupta, Barthelemy Liabaud, Justin K Scheer, Bassel G Diebo, Themistocles S Protopsaltis, Michael P Kelly, Vedat Deviren, Robert Hart, Doug Burton, Shay Bess, Christopher P Ames
OBJECTIVE Although 3-column osteotomy (3CO) can provide powerful alignment correction in adult spinal deformity (ASD), these procedures are complex and associated with high complication rates. The authors' objective was to assess complications associated with ASD surgery that included 3CO based on a prospectively collected multicenter database. METHODS This study is a retrospective review of a prospectively collected multicenter consecutive case registry. ASD patients treated with 3CO and eligible for 2-year follow-up were identified from a prospectively collected multicenter ASD database...
February 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28264237/risk-factors-of-proximal-junctional-kyphosis-after-multilevel-fusion-surgery-more-than-2-years-follow-up-data
#14
Do Keun Kim, Ji Yong Kim, Do Yeon Kim, Seung Chul Rhim, Seung Hwan Yoon
OBJECTIVE: Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >10° at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. METHODS: A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28263226/age-adjusted-alignment-goals-have-the-potential-to-reduce-pjk
#15
Renaud Lafage, Frank Schwab, Steve Glassman, Shay Bess, Bradley Harris, Justin Sheer, Robert Hart, Breton Line, Jensen Henry, Doug Burton, HanJo Kim, Eric Klineberg, Christopher Ames, Virginie Lafage
STUDY DESIGN: Retrospective cohort OBJECTIVE.: To explore proximal junctional kyphosis(PJK) as a function of age-adjusted surgical correction goals. SUMMARY OF BACKGROUND DATA: Recent adult spinal deformity(ASD) studies show that alignment targets are age-specific. Despite recognizing age and malalignment as PJK risk factors, no study has assessed the age-specific effects of alignment on PJK. METHODS: ASD patients with fusions to the pelvis were included and stratified into three groups: young adults(YA<40yo), middle aged(MA: 40-65yo), the elderly(ED>65yo)...
March 3, 2017: Spine
https://www.readbyqxmd.com/read/28242335/rod-stiffness-as-a-risk-factor-of-proximal-junctional-kyphosis-after-adult-spinal-deformity-surgery-comparative-study-between-cobalt-chrome-multiple-rod-constructs-and-titanium-alloy-two-rod-constructs
#16
Sanghyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Subum Lee, Seung-Chul Rhim
BACKGROUND CONTEXT: Little is known about the effect of rod stiffness as a risk factor of proximal junctional kyphosis (PJK) after adult spinal deformity (ASD) surgery. PURPOSE: The aim of this study was to compare radiographic outcomes after the use of cobalt chrome multiple-rod constructs (CoCr MRCs) and titanium alloy two-rod constructs (Ti TRCs) for ASD surgery with a minimum 1-year follow-up. STUDY DESIGN: Retrospective case-control study in two institutes...
February 24, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28241720/-proximal-junctional-kyphosis-after-posterior-hemivertebra-resection-and-instrumented-fusion-in-young-children-with-congenital-scoliosis
#17
X Sun, X Chen, Z H Chen, Z Z Zhu, F Zhu, Z Liu, B P Qian, B Wang, J Qiao, Y Qiu
Objective: To investigate the risk factors of proximal junctional kyphosis(PJK) in young children who underwent posterior hemivertebra resection and instrumented fusion. Methods: This study reviewed the charts and radiographs of 136 consecutive young children with congenital scoliosis who underwent posterior hemivertebra resection and instrumented fusion in Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2009 to June 2014, including 75 males and 61 females, with an average age of (5...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28222402/impact-of-anchor-type-on-porcine-lumbar-biomechanics-finite-element-modelling-and-in-vitro-validation
#18
Martin Brummund, Vladimir Brailovski, Yvan Petit, Yann Facchinello, Jean-Marc Mac-Thiong
BACKGROUND: Rigid posterior implants used for spinal stabilization can be anchored to the vertebrae using pedicle screws or screws combined with transverse process hooks. In the present study, a finite element model of a porcine lumbar spine instrumented with screws and hooks is presented and validated. METHODS: The porcine lumbar spine model was validated using in-vitro measurements on six porcine specimens. Validation metrics included intervertebral rotations (L1 to L6) and nucleus pressure in the topmost cranial instrumented disc...
February 14, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28216210/prevention-of-proximal-junctional-kyphosis-are-polyaxial-pedicle-screws-superior-to-monoaxial-pedicle-screws-at-the-upper-instrumented-vertebrae
#19
Hui Wang, Wenyuan Ding, Lei Ma, Lijun Zhang, Dalong Yang
INTRODUCTION: Evidence regarding whether the polyaxial pedicle screws at the upper instrumented vertebrae (UIV) are superior to monoaxial pedicle screws in prevention of proximal junctional kyphosis (PJK) is not clear. The aim of this study was therefore to explore the influence of different types of pedicle screws at UIV on the incidence of PJK. METHODS: We reviewed retrospectively 242 patients surgically treated with instrumented segmental posterior spinal fusion at a minimum of 4 motion segments...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28187070/proximal-junctional-kyphosis-after-posterior-spinal-instrumentation-and-fusion-in-young-children-with-congenital-scoliosis-a-preliminary-report-on-its-incidence-and-risk-factors
#20
Xi Chen, Zhong-Hui Chen, Yong Qiu, Ze-Zhang Zhu, Song Li, Liang Xu, Xu Sun
STUDY DESIGN: A retrospective study. OBJECTIVE: To determine the incidence and risk factors of proximal junctional kyphosis (PJK) in young children who underwent posterior instrumented spinal fusion. SUMMARY OF BACKGROUND DATA: PJK is a well-recognized postoperative complication in adults and adolescents. However, there is a paucity of valid data with regard to PJK in young children with congenital scoliosis who were treated with posterior correction surgery...
February 9, 2017: Spine
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