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Proximal junction kyphosis

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https://www.readbyqxmd.com/read/27889355/cervical-sagittal-alignment-in-adult-hyperkyphosis-treated-by-posterior-instrumentation-and-in-situ-bending
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27689140/flexible-growing-rods-a-biomechanical-pilot-study-of-polymer-rod-constructs-in-the-stability-of-skeletally-immature-spines
#9
Donita I Bylski-Austrow, David L Glos, Anne C Bonifas, Max F Carvalho, Matthew C Coombs, Peter F Sturm
BACKGROUND: Surgical treatments for early onset scoliosis (EOS) correct curvatures and improve respiratory function but involve many complications. A distractible, or 'growing rod,' implant construct that is more flexible than current metal rod systems may sufficiently correct curves in small children and reduce complications due to biomechanical factors. The purpose of this pilot study was to determine ranges of motion (ROM) after implantation of simulated growing rod constructs with a range of clinically relevant structural properties...
2016: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/27611508/the-effect-of-posterior-polyester-tethers-on-the-biomechanics-of-proximal-junctional-kyphosis-a-finite-element-analysis
#10
Shay Bess, Jeffrey E Harris, Alexander W L Turner, Virginie LaFage, Justin S Smith, Christopher I Shaffrey, Frank J Schwab, Regis W Haid
OBJECTIVE Proximal junctional kyphosis (PJK) remains problematic following multilevel instrumented spine surgery. Previous biomechanical studies indicate that providing less rigid fixation at the cranial aspect of a long posterior instrumented construct, via transition rods or hooks at the upper instrumented vertebra (UIV), may provide a gradual transition to normal motion and prevent PJK. The purpose of this study was to evaluate the ability of posterior anchored polyethylene tethers to distribute proximal motion segment stiffness in long instrumented spine constructs...
September 9, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27587527/the-use-of-magnetically-controlled-growing-rods-to-treat-children-with-early-onset-scoliosis-early-radiological-results-in-19-children
#11
W Thompson, C Thakar, D J Rolton, J Wilson-MacDonald, C Nnadi
AIMS: We undertook a prospective non-randomised radiological study to evaluate the preliminary results of using magnetically-controlled growing rods (MAGEC System, Ellipse technology) to treat children with early-onset scoliosis. PATIENTS AND METHODS: Between January 2011 and January 2015, 19 children were treated with magnetically-controlled growing rods (MCGRs) and underwent distraction at three-monthly intervals. The mean age of our cohort was 9.1 years (4 to 14) and the mean follow-up 22...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27557450/mismatch-between-proximal-rod-contouring-and-proximal-junctional-angle-a-predisposed-risk-factor-for-proximal-junctional-kyphosis-in-degenerative-scoliosis
#12
Peng Yan, Hongda Bao, Yong Qiu, Mike Bao, Jeffrey J Varghese, Xu Sun, Zhen Liu, Zezhang Zhu, Bangping Qian, Minghao Zheng, Feng Zhu
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate whether the mismatch between proximal junctional angle (PJA) and the proximal rod contouring contributed to the occurrence of post-operative PJK in degenerative scoliosis. SUMMARY OF BACKGROUND DATA: Proximal junctional kyphosis (PJK) is one of the complications in the treatment of degenerative scoliosis, the post-operative PI-LL mismatch and the increased rod stiffness are supposed to be the etiology of PJK...
August 24, 2016: Spine
https://www.readbyqxmd.com/read/27535632/spinal-implant-density-and-postoperative-lumbar-lordosis-as-predictors-for-the-development-of-proximal-junctional-kyphosis-in-adult-spinal-deformity
#13
Jamal McClendon, Timothy R Smith, Patrick A Sugrue, Sara E Thompson, Brian A O'Shaughnessy, Tyler R Koski
OBJECTIVE: To evaluate spinal implant density and proximal junctional kyphosis (PJK) in adult spinal deformity (ASD). METHODS: Consecutive ASD patients receiving >5 level fusions were retrospectively analyzed between 2007 and 2010. INCLUSION CRITERIA: ASD, elective fusions, minimum 2-year follow-up. EXCLUSION CRITERIA: Age < 18 years, neuromuscular or congenital scoliosis, cervical or cervicothoracic fusions, non-elective conditions (infection, tumor, trauma)...
August 12, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27512860/incidence-and-risk-factors-for-the-progression-of-proximal-junctional-kyphosis-in-degenerative-lumbar-scoliosis-following-long-instrumented-posterior-spinal-fusion
#14
Hui Wang, Lei Ma, Dalong Yang, Tao Wang, Sidong Yang, Yanhong Wang, Qian Wang, Feng Zhang, Wenyuan Ding
The aim of this study was to identify the prevalence of proximal junctional kyphosis (PJK) in degenerative lumbar scoliosis (DLS) following long instrumented posterior spinal fusion, and to search for predictable risk factors for the progression of junctional kyphosis.In total 98 DLS patients with a minimum 2-year follow-up were reviewed prospectively. According to the occurrence of PJK at the last follow-up, patients were divided into 2 groups: PJK group and non-PJK group. To investigate risk values for the progression of PJK, 3 categorized factors were analyzed statistically: patient characteristics-preoperative data of age, sex, body mass index (BMI), bone mineral density (BMD) were investigated; surgical variables-the most proximal and distal levels of the instrumentation, the number of instrumented levels; pre- and postoperative radiographic parameters include the scoliotic angle, sagittal vertical axis, thoracic kyphosis, thoracolumbar junctional angle, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27471900/management-of-spinal-deformity-in-adult-patients-with-neuromuscular-disease
#15
Themistocles S Protopsaltis, Anthony J Boniello, Frank J Schwab
A wide range of neuromuscular diseases, including Parkinson disease, cerebral palsy, multiple sclerosis, and myopathy, are associated with spinal deformities. The most common postural deformities include anterocollis, Pisa syndrome (pleurothotonus), scoliosis, and camptocormia. Nonsurgical management of spinal deformity in patients with neuromuscular disease centers on maximizing the medical management of the underlying neurodegenerative pathology before surgical intervention is contemplated. Surgical management can include decompression alone, or decompression and fusion with short or long fusion constructs...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27437690/cervical-sagittal-deformity-develops-after-pjk-in-adult-thoracolumbar-deformity-correction-radiographic-analysis-utilizing-a-novel-global-sagittal-angular-parameter-the-ctpa
#16
Themistocles Protopsaltis, Nicolas Bronsard, Alex Soroceanu, Jensen K Henry, Renaud Lafage, Justin Smith, Eric Klineberg, Gregory Mundis, Han Jo Kim, Richard Hostin, Robert Hart, Christopher Shaffrey, Shay Bess, Christopher Ames
PURPOSE: To describe reciprocal changes in cervical alignment after adult spinal deformity (ASD) correction and subsequent development of proximal junctional kyphosis (PJK). This study also investigated these changes using two novel global sagittal angular parameters, cervical-thoracic pelvic angle (CTPA) and the T1 pelvic angle (TPA). METHODS: Multicenter, retrospective consecutive case series of ASD patients undergoing thoracolumbar three-column osteotomy (3CO) with fusion to the pelvis...
July 20, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27435487/incidence-of-proximal-junctional-kyphosis-with-magnetic-expansion-control-rods-in-early-onset-scoliosis
#17
P Inaparthy, J C Queruz, D Bhagawati, C Thakar, T Subramanian, C Nnadi
BACKGROUND: The introduction of magnetic expansion control growth rods for the surgical management of EOS has gained popularity. However, there are no published studies on the incidence of proximal junctional kyphosis (PJK) using this technique. PURPOSE: The aim of this study is to report the incidence of PJK following treatment with magnetic growth rods in EOS. METHODS: Retrospective review of data from 21 cases (12 males, 9 females) over 3 years...
October 2016: European Spine Journal
https://www.readbyqxmd.com/read/27411527/role-of-minimally-invasive-surgery-for-adult-spinal-deformity-in-preventing-complications
#18
REVIEW
Chun-Po Yen, Yusef I Mosley, Juan S Uribe
With the aging population, there is a rising prevalence of degenerative spinal deformity and need of surgical care for these patients. Surgical treatment for adult spinal deformity (ASD) is often fraught with a high rate of complications. Minimally invasive surgery (MIS) has for the past decade been adopted by spine surgeons to treat ASD in the hopes of reducing access-related morbidity and perioperative complications. The benefits of MIS approach in general and recent development of MIS techniques to avoid long-term complications such as pseudoarthrosis or proximal junctional kyphosis are reviewed...
September 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27403916/surgical-management-of-progressive-thoracolumbar-kyphosis-in-mucopolysaccharidosis-is-a-posterior-only-approach-safe-and-effective
#19
Senol Bekmez, Halil G Demirkiran, Ozgur Dede, Vusal Ismayilov, Muharrem Yazici
BACKGROUND: According to the current literature, the recommended surgical treatment is circumferential spinal fusion, including both anterior and posterior procedures, for progressive thoracolumbar kyphosis in mucopolysaccharidosis (MPS). The purpose of this study was to report our experience with the posterior-only approach and instrumented fusion for MPS kyphosis. METHODS: Six consecutive patients with MPS and thoracolumbar junctional kyphosis managed with the posterior-only approach were included...
July 11, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27401875/anterior-versus-posterior-approach-in-lenke-5c-adolescent-idiopathic-scoliosis-a-meta-analysis-of-fusion-segments-and-radiological-outcomes
#20
Ming Luo, Wengang Wang, Mingkui Shen, Lei Xia
BACKGROUND: Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial. Meta-analysis on published articles to compare fusion segments and radiological outcomes between the two surgical approaches was performed. METHODS: Electronic database was conducted for searching studies concerning the anterior versus posterior approach in Lenke 5C curves. After quality assessment, data of means, standard deviations, and sample sizes were extracted...
2016: Journal of Orthopaedic Surgery and Research
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