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Proximal junction kyphosis

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https://www.readbyqxmd.com/read/28922883/proximal-junctional-kyphosis-prevention-strategies-a-video-technique-guide
#1
Michael M Safaee, Joseph A Osorio, Kushagra Verma, Shay Bess, Christopher I Shaffrey, Justin S Smith, Robert Hart, Vedat Deviren, Christopher P Ames
BACKGROUND: Proximal junctional kyphosis (PJK) is a well-recognized complication in patients undergoing posterior instrumented fusion procedures for adult spinal deformity. Strategies that reduce rates of PJK have the potential to improve the safety of these operations and decrease cost by eliminating the need for revision surgery. OBJECTIVE: To present a set of surgical techniques that can decrease rates of PJK in adults undergoing surgery for spinal deformity...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28902106/fine-tuning-the-predictive-model-for-proximal-junctional-failure-in-surgically-treated-patients-with-adult-spinal-deformity
#2
Mitsuru Yagi, Nobuyuki Fujita, Eijiro Okada, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: Multi-center retrospective study. OBJECTIVE: To validate and improve the predictive model for proximal junctional failure (PJF) with or without the bone mineral density (BMD) score. SUMMARY OF BACKGROUND DATA: PJF is a serious complication of surgery for adult spinal deformity (ADS). A predictive model for PJF was recently reported that has good accuracy, but does not include BMD, a known PJF risk factor, as a variable. METHODS: We included 145 surgically treated ASD patients who were older than 50 at the time of surgery and had been followed up for at least 2 years...
September 8, 2017: Spine
https://www.readbyqxmd.com/read/28887273/use-of-the-dual-construct-for-the-management-of-complex-spinal-reconstructions
#3
Francis H Shen, Rabia Qureshi, Rose Tyger, Rebecca Lehman, Anuj Singla, Adam Shimer, Hamid Hassanzadeh
BACKGROUND CONTEXT: Surgical management of complex spinal reconstructions remains a clinical challenge, as pseudoarthrosis with subsequent rod breakage can occur. Increased rod density in the form of "satellite" or "outrigger" rods have been described; however rod-fracture above or below satellite rods persist and can result in dissociation of the construct, loss of correction, and recurrence of deformity. The use of four distinct and mechanically independent rods (Dual Construct) reduces this concern...
September 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28882354/surgical-treatment-with-pedicle-screws-of-scoliosis-associated-with-osteogenesis-imperfecta-in-children
#4
Lucas Piantoni, Mariano A Noel, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, Ernesto S Bersusky
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess results of posterior instrumented fusion using pedicle screws in 12 children with osteogenesis imperfecta (OI) with spinal deformity at a single institution from 2001 to 2012. SUMMARY OF BACKGROUND DATA: This is the first case series of OI patients who underwent non-cement augmented screw-rod instrumented fusion published in the literature. METHODS: Of a total of 54 children with spinal deformity associated with OI, 12 (22...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28874968/posterior-only-approach-with-pedicle-screws-for-the-correction-of-scheuermann-s-kyphosis
#5
Adem Cobden, Akif Albayrak, Yalkin Camurcu, Hakan Sofu, Temel Tacal, Mehmet Akif Kaygusuz
STUDY DESIGN: Retrospective study (level of evidence: level 3). PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of the posterior-only approach with pedicle screws for the treatment of Scheuermann's kyphosis (SK). OVERVIEW OF LITERATURE: The correction of SK with instrumentation can be performed using posterior-only or combined anterior-posterior procedures. With the use of all-pedicle screw constructs in spine surgery, the posterior-only approach has become a popular option for the definitive treatment of SK...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28853596/a-novel-technique-to-reduce-proximal-junctional-kyphosis-in-adults
#6
L Tillotson, O M Stokes, D Chan
No abstract text is available yet for this article.
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28799837/effectiveness-of-deformity-correction-surgery-for-primary-degenerative-sagittal-imbalance-a-meta-analysis
#7
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim, Seung-Jae Hyun
OBJECTIVE As life expectancy continues to increase, primary degenerative sagittal imbalance (PDSI) is diagnosed in an increasing number of elderly people. Although corrective surgery for this sagittal deformity is becoming more popular, the effectiveness of the procedure remains unclear. The authors aimed to collate the available evidence on the effectiveness and complications of deformity-correction surgery in patients with PDSI. METHODS The authors carried out a meta-analysis of clinical studies regarding deformity correction in patients with PDSI...
August 11, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28767638/low-bone-mineral-density-is-a-significant-risk-for-proximal-junctional-failure-after-surgical-correction-of-adult-spinal-deformity-a-propensity-score-matched-analysis
#8
Mitsuru Yagi, Nobuyuki Fujita, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: A propensity-matched comparison of risk factors for proximal junctional failure (PJF), which is a symptomatic proximal junctional kyphosis developing after corrective surgery for adult spinal deformity (ASD). OBJECTIVE: To elucidate the role of bone strength for developing PJF. SUMMARY OF BACKGROUND DATA: PJF, a devastating complication of corrective surgery for ASD, often recurs even after revision surgery. Most studies of risk factors for PJF are retrospective and have a selection bias in surgical strategy, making it difficult to identify modifiable PJF risk factors...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28682881/pedicle-screw-versus-hybrid-instrumentation-in-adolescent-idiopathic-scoliosis-a-systematic-review-and-meta-analysis-with-emphasis-on-complications-and-reoperations
#9
REVIEW
Ming Luo, Ning Li, Mingkui Shen, Lei Xia
BACKGROUND: Incidence of complications and reoperations between pedicle screw (PS) and hybrid instrumentations (HI) are still controversial in adolescent idiopathic scoliosis (AIS) patients. A systematic review and meta-analysis were performed to compare overall complications, reoperations, and radiographic outcomes between the 2 constructs. METHODS: Strictly followed the PRISMA 2009 guidelines, the MEDLINE, EMBASE, and the Cochrane Library databases were used to search for literatures up to April 2016, addressing PS versus HI in AIS patients...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28660108/distal-fusion-level-selection-in-scheuermann-s-kyphosis-a-comparison-of-lordotic-disc-segment-versus-the-sagittal-stable-vertebrae
#10
Han Jo Kim, Venu Nemani, Oheneba Boachie-Adjei, Matthew E Cunningham, Justin A Iorio, Kevin O'Neill, Brian J Neuman, Lawrence G Lenke
STUDY DESIGN: Retrospective study. OBJECTIVE: To compare 2 methods of selecting the lowest instrumented vertebra (LIV) on the rates of revision surgery for distal junctional kyphosis (DJK) following treatment for Scheuermann's kyphosis (SK). METHODS: A retrospective review of patients who have undergone surgical treatment for SK was performed. Forty-four patients were divided into 2 groups based on intervention: Group 1 (n = 26) included patients who had an LIV distal to or at the sagittal stable vertebrae (SSV), and Group 2 (n = 18) included patients who had an LIV proximal to the SSV...
May 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28658032/assessment-of-the-change-in-alignment-of-fixed-segment-after-adult-spinal-deformity-surgery
#11
Tomohiro Banno, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Daisuke Togawa, Go Yoshida, Tatsuya Yasuda, Shin Oe, Yuki Mihara, Hiroki Ushirozako, Yukihiro Matsuyama
STUDY DESIGN: Retrospective study OBJECTIVE.: To determine the prevalence of loss in fixed segment alignment after surgical correction of adult spinal deformity (ASD) and identify associated risk factors. SUMMARY OF BACKGROUND DATA: Altered fixed segment alignment influences global spinal alignment; however, associated risk factors have not been determined. METHODS: Data of 63 patients with ASD (55 women; mean age, 68.0 years), who underwent corrective fusion from the lower thoracic spine to the pelvis and completed the 2-year follow-up, were retrospectively analyzed...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28597300/proximal-junctional-kyphosis-in-adult-scoliosis-comparison-of-four-radiological-predictor-models
#12
Amer Sebaaly, Guillaume Riouallon, Ibrahim Obeid, Pierre Grobost, Maroun Rizkallah, Fethi Laouissat, Yann-Phillippe Charles, Pierre Roussouly
OBJECTIVE: The objective of this retrospective study is to identify the best immediate postoperative radiological predictors for the occurrence of proximal junctional kyphosis (PJK). Four proposed methods will be explored. METHODS: A homogeneous database of adult scoliosis from multiple centers was used. Patients with whole spine X-rays at the required follow-up (FU) periods were included. Spinal and pelvic parameters were measured and calculated to compare four predictive methods: Method 1: assessment of the global sagittal alignment (GSA); Method 2: restoration of the theoretical values of lumbar lordosis (LL) and thoracic kyphosis (TK) according to pelvic incidence (PI); Method 3: evaluation of TK + LL, and Method 4: restoration of the apex of sagittal LL to its theoretical values according to various spine shapes in Roussouly Classification...
June 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28592076/-effects-of-different-pelvic-incidence-minus-lumbar-lordosis-mismatch-after-long-posterior-instrumentation-and-fusion-for-adult-degenerative-scoliosis
#13
X Y Sun, Y Hai, X N Zhang
Objective: To evaluate the influence of PI-LL (pelvic incidence minus lumbar lordosis mismatch) on scoliosis correction, living quality and internal fixation related complications for adult degenerative scoliosis (ASD) after long posterior instrumentation and fusion. Methods: A total of 79 patients with ADS underwent long posterior instrumentation and fusion in the Department of Orthopedics at Beijing Chao Yang Hospital from January 2010 to January 2014 were retrospectively reviewed.There were 21 males and 58 females aging from 55 to 72 years with the mean age (63...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28591078/proximal-junctional-kyphosis-inter-and-intra-observer-reliability-of-radiographic-measurements-in-adult-spinal-deformity
#14
Farbod Rastegar, Alec Contag, Alan Daniels, Jayme Hiratzka, Clifford Lin, Jason Chang, Khoi Than, Ahmed Raslan, Christopher Kong, Ngoc-Lam Nguyen, Richard Hostin, Marie Kane, Robert Hart
STUDY DESIGN: Reliability study of radiographic measures of proximal junctional kyphosis in adult spinal deformity patients. OBJECTIVE: Assess impacts of level of proximal endpoint and vertebral fracture on reliability of measurement of junctional kyphosis. SUMMARY OF BACKGROUND DATA: Radiographic assessment is important in determining management of patients with Proximal Junctional Kyphosis (PJK) or Proximal Junctional Failure (PJF). No study to date has evaluated the reliability of radiographic measurement of the junctional kyphotic angle after surgery for Adult Spinal Deformity (ASD)...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28548996/distal-junctional-failure-following-pediatric-spinal-fusion
#15
Lorena V Floccari, Alvin W Su, Amy L McIntosh, Karl Rathjen, William J Shaughnessy, A Noelle Larson
BACKGROUND: Adjacent segment pathology is a known complication after spinal fusion, but little has been reported on junctional failure. A series of adolescent patients presented with acute distal junctional failure (DJF). We sought to determine any common features of these patients to develop a prevention strategy. METHODS: A retrospective review was conducted of pediatric patients who developed DJF after instrumented spinal fusion performed at 2 institutions from 1999 to 2013...
August 4, 2017: Journal of Pediatric Orthopedics
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
#16
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: The study aimed 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
#17
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
#18
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
#19
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
#20
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
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