BACKGROUND: Proximal junctional kyphosis (PJK) is a common complication after corrective long spinal fusion for adult spinal deformity. Although some reports evaluated PJK after corrective long spinal fusion, there is no report about analysis of PJK cases in the same fusion area. The purpose of this study to investigated the incidence of and risk factors for PJK in adults undergoing long spinal fusion from the distal thoracic vertebrae (T9/T10) to the ilium. METHODS: We enrolled 56 adult patients (>40 years of age) who underwent posterior corrective surgery with same fusion area from T9 or T10 to the ilium for spinal deformity. Pre- and postoperative radiographic measurements included the sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), and pelvic incidence minus LL (PI-LL). The Oswestry disability index (ODI) was used to evaluate patient outcomes preoperatively and one year after surgery. We analyzed the incidence for PJK and compared PJK and non-PJK cases. RESULTS: PJK at the final follow-up occurred in 19 of 56 (33.9%) patients. The mean age and ODI were not significantly different between the PJK and non-PJK groups. Both two groups had good spinopelvic sagittal alignment after surgery in terms of SVA and PI-LL. Only three cases required revision surgery for symptomatic PJK. Three cases had history of rheumatoid arthritis and/or total hip arthroplasty surgery. CONCLUSIONS: The incidence of PJK was 33.9%, and ODI was not significantly different between the PJK and non-PJK groups. Symptomatic PJK was only three cases and all of them had lower extremity joint disorders. We should pay attention also lower extremity joint to prevent symptomatic PJK at the lower thoracic level.
BACKGROUND: Proximal junctional kyphosis (PJK) is a common complication after corrective long spinal fusion for adult spinal deformity. Although some reports evaluated PJK after corrective long spinal fusion, there is no report about analysis of PJK cases in the same fusion area. The purpose of this study to investigated the incidence of and risk factors for PJK in adults undergoing long spinal fusion from the distal thoracic vertebrae (T9/T10) to the ilium. METHODS: We enrolled 56 adult patients (>40 years of age) who underwent posterior corrective surgery with same fusion area from T9 or T10 to the ilium for spinal deformity. Pre- and postoperative radiographic measurements included the sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), and pelvic incidence minus LL (PI-LL). The Oswestry disability index (ODI) was used to evaluate patient outcomes preoperatively and one year after surgery. We analyzed the incidence for PJK and compared PJK and non-PJK cases. RESULTS: PJK at the final follow-up occurred in 19 of 56 (33.9%) patients. The mean age and ODI were not significantly different between the PJK and non-PJK groups. Both two groups had good spinopelvic sagittal alignment after surgery in terms of SVA and PI-LL. Only three cases required revision surgery for symptomatic PJK. Three cases had history of rheumatoid arthritis and/or total hip arthroplasty surgery. CONCLUSIONS: The incidence of PJK was 33.9%, and ODI was not significantly different between the PJK and non-PJK groups. Symptomatic PJK was only three cases and all of them had lower extremity joint disorders. We should pay attention also lower extremity joint to prevent symptomatic PJK at the lower thoracic level.
Authors: Frank Schwab; Benjamin Ungar; Benjamin Blondel; Jacob Buchowski; Jeffrey Coe; Donald Deinlein; Christopher DeWald; Hossein Mehdian; Christopher Shaffrey; Clifford Tribus; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2012-05-20 Impact factor: 3.468
Authors: Han Jo Kim; Keith H Bridwell; Lawrence G Lenke; Moon Soo Park; Kwang Sup Song; Chaiwat Piyaskulkaew; Tapanut Chuntarapas Journal: Spine (Phila Pa 1976) Date: 2014-04-20 Impact factor: 3.468
Authors: Han Jo Kim; Mitsuru Yagi; Joseph Nyugen; Matthew E Cunningham; Oheneba Boachie-Adjei Journal: Clin Orthop Relat Res Date: 2012-06 Impact factor: 4.176
Authors: Steven D Glassman; Keith Bridwell; John R Dimar; William Horton; Sigurd Berven; Frank Schwab Journal: Spine (Phila Pa 1976) Date: 2005-09-15 Impact factor: 3.468
Authors: William C Horton; Courtney W Brown; Keith H Bridwell; Steven D Glassman; Se-Il Suk; Charles W Cha Journal: Spine (Phila Pa 1976) Date: 2005-02-15 Impact factor: 3.468
Authors: Yongjung J Kim; Keith H Bridwell; Lawrence G Lenke; Gene Cheh; Christine Baldus Journal: Spine (Phila Pa 1976) Date: 2007-09-15 Impact factor: 3.468
Authors: Yongjung J Kim; Keith H Bridwell; Lawrence G Lenke; Chris R Glattes; Seungchul Rhim; Gene Cheh Journal: Spine (Phila Pa 1976) Date: 2008-09-15 Impact factor: 3.468