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Proximal junction kyphosis

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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 less clear. The aim of this study was therefore to explore the influence of different type of pedicle screws at UIV on the incidence of PJK. METHODS: 242 patients surgically treated with instrumented segmental posterior spinal fusion at a minimum 4 motion segments were reviewed retrospectively...
February 12, 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
#9
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
https://www.readbyqxmd.com/read/28187069/virtual-modeling-of-postoperative-alignment-following-adult-spinal-deformity-asd-surgery-helps-predict-associations-between-compensatory-spinopelvic-alignment-changes-overcorrection-and-proximal-junctional-kyphosis-pjk
#10
Renaud Lafage, Shay Bess, Steve Glassman, Christopher Ames, Doug Burton, Robert Hart, Han Jo Kim, Eric Klineberg, Jensen Henry, Breton Line, Justin Scheer, Themistocles Protopsaltis, Frank Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multicenter database. OBJECTIVE: To develop a method to analyze sagittal alignment, free of PJK's influence, and then compare PJK to non-PJK patients using this method. SUMMARY OF BACKGROUND DATA: Proximal Junctional Kyphosis (PJK) following Adult Spinal Deformity (ASD) surgery remains problematic as it alters sagittal alignment. This study proposes a novel virtual modeling technique that attempts to eliminate the confounding effects of PJK on postoperative spinal alignment...
February 9, 2017: Spine
https://www.readbyqxmd.com/read/28173513/different-risk-factors-of-proximal-junctional-kyphosis-and-proximal-junctional-failure-following-long-instrumented-fusion-to-the-sacrum-for-adult-spinal-deformity-survivorship-analysis-of-160-patients
#11
Se-Jun Park, Chong-Suh Lee, Sung-Soo Chung, Jun-Young Lee, Sang-Soo Kang, Se-Hwan Park
No abstract text is available yet for this article.
February 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28040873/magnetically-controlled-growing-rod-in-early-onset-scoliosis-a-30-case-multicenter-study
#12
REVIEW
Julie Lebon, Cécile Batailler, Matthieu Wargny, Elie Choufani, Philippe Violas, Damien Fron, Jerry Kieffer, Franck Accadbled, Vincent Cunin, Jérôme Sales De Gauzy
PURPOSE: Preliminary results of magnetically controlled growing rods (MCGR) are encouraging. However, only short case series of MCGR for the treatment of early onset scoliosis (EOS) have been reported. Our aim was to evaluate its effectiveness and complications. METHODS: We report a 30-case retrospective, consecutive, multicenter series of MCGR. Effectiveness was judged upon: deformity correction and difficulties to achieve desired distraction. Secondary endpoints included complications and revision surgeries...
December 31, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27889355/cervical-sagittal-alignment-in-adult-hyperkyphosis-treated-by-posterior-instrumentation-and-in-situ-bending
#13
F Paternostre, Y P Charles, E A Sauleau, J-P Steib
BACKGROUND: In the normal adult spine, a link between thoracolumbar and cervical sagittal alignment exists, suggesting adaptive cervical positional changes allowing horizontal gaze. In patients with thoracic hyperkyphosis, cervical adaptation to sagittal global alignment might be different from healthy individuals. However, this relationship has not clearly been reported in hyperkyphotic deformity. PURPOSE: The purpose of this study was to identify cervical sagittal alignment types observed on radiographs in young adults with thoracic hyperkyphosis...
November 23, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#14
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27852709/long-fusion-correction-of-degenerative-adult-spinal-deformity-and-the-selection-of-the-upper-or-lower-thoracic-region-as-the-site-of-proximal-instrumentation-a-systematic-review-and-meta-analysis
#15
Xin Fu, Xiao-Lei Sun, Jonathan A Harris, Sun-Ren Sheng, Hua-Zi Xu, Yong-Long Chi, Ai-Min Wu
OBJECTIVE: The aim of this study was to compare outcomes when the upper and lower thoracic regions were used as the site of proximal instrumentation to treat adult spinal deformity. METHODS: MEDLINE, Embase and Cochrane library searches were performed to identify studies that compared outcome measures when the upper and lower thoracic vertebrae (UTV and LTV, respectively) were used as the site of proximal instrumentation. The weighted mean difference (WMD) was calculated for continuous outcomes, and the relative risk (RR) was calculated for dichotomous outcomes...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27831987/development-of-validated-computer-based-preoperative-predictive-model-for-proximal-junction-failure-pjf-or-clinically-significant-pjk-with-86-accuracy-based-on-510-asd-patients-with-2-year-follow-up
#16
Justin K Scheer, Joseph A Osorio, Justin S Smith, Frank Schwab, Virginie Lafage, Robert A Hart, Shay Bess, Breton Line, Bassel G Diebo, Themistocles S Protopsaltis, Amit Jain, Tamir Ailon, Douglas C Burton, Christopher I Shaffrey, Eric Klineberg, Christopher P Ames
STUDY DESIGN: A retrospective review of large, multicenter adult spinal deformity (ASD) database. OBJECTIVE: The aim of this study was to build a model based on baseline demographic, radiographic, and surgical factors that can predict clinically significant proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). SUMMARY OF BACKGROUND DATA: PJF and PJK are significant complications and it remains unclear what are the specific drivers behind the development of either...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27824791/how-does-hyperkyphotic-early-onset-scoliosis-respond-to-growing-rod-treatment
#17
Zhonghui Chen, Yong Qiu, Zezhang Zhu, Song Li, Xi Chen, Xu Sun
BACKGROUND: Growing rods (GRs) pose a higher risk of kyphosis gain while improving coronal deformity with intermittent distractions in early-onset scoliosis (EOS), but in turn, increased kyphosis may also affect GR correction outcomes. However, there is a paucity of data regarding the effect of GRs on the sagittal spinal profiles in hyperkyphotic EOS. Thus, we aim to demonstrate how hyperkyphotic EOS responds to GRs treatment. METHODS: Forty patients treated with GRs for EOS were included and categorized into a normal kyphosis (N) group [20 degrees≤thoracic kyphosis (TK)≤50 degrees] or hyperkyphosis group (K) group (TK≥50 degrees)...
November 7, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27817137/titanium-vs-cobalt-chromium-what-is-the-best-rod-material-to-enhance-adolescent-idiopathic-scoliosis-correction-with-sublaminar-bands
#18
Audrey Angelliaume, E Ferrero, K Mazda, M Le Hanneur, F Accabled, J Sales de Gauzy, B Ilharreborde
PURPOSE: Cobalt chromium (CoCr) rods have recently gained popularity in adolescent idiopathic scoliosis (AIS) surgical treatment, replacing titanium (Ti) rods, with promising frontal correction rates in all-screw constructs. Posteromedial translation has been shown to emphasize thoracic sagittal correction, but the influence of rod material in this correction technique has never been investigated. The aim of this study was to compare the postoperative correction between Ti and CoCr rods for the treatment of thoracic AIS using posteromedial translation technique...
November 5, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27735976/semitendinosus-graft-for-interspinous-ligament-reinforcement-in-adult-spinal-deformity
#19
Martin H Pham, Alexander Tuchman, Lance Smith, Andre M Jakoi, Neil N Patel, Vivek A Mehta, Frank L Acosta
Proximal junctional kyphosis is an increasingly recognized complication following long-segment posterior spinal fusion for adult spinal deformity. The authors describe a novel technique for interspinous ligament reinforcement at the proximal adjacent levels using a cadaveric semitendinosus tendon graft secured with an Ethibond No. 2 double filament (Ethicon, Somerville, New Jersey) via the Krackow suture weave. A retrospective review identified 4 patients who had received this graft. No proximal junctional kyphosis was seen at a mean short-term follow-up of 5...
October 13, 2016: Orthopedics
https://www.readbyqxmd.com/read/27704285/cobb-1-versus-cobb-to-cobb-anterior-fusion-for-adolescent-idiopathic-scoliosis-lenke-5c-curves-a-radiological-comparative-study
#20
Arnaud Dubory, Lotfi Miladi, Brice Ilharreborde, Jean-Marie Gennari, Jihane Rouissi, Christophe Glorion, Charles Henri Flouzat Lachaniette, Thierry Odent
PURPOSE: Anterior fusion is a well-established procedure for the treatment of Lenke 5C adolescent idiopathic scoliosis (AIS). This retrospective study aimed to assess preoperative and postoperative radiographic differences between the conventional anterior fusion and anterior short fusions (ASF) in Lenke 5C AIS. METHODS: Radiographic data of 42 consecutive cases of Lenke 5C AIS, which were surgically treated through anterior segmental fusion, were analyzed retrospectively...
October 4, 2016: European Spine Journal
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