Incidence of Proximal Junctional Kyphosis With Pedicle Screws at Upper Instrumented Vertebrae in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Global Spine Journal
Yoji OguraLeah Y Carreon

Abstract

Longitudinal cohort. Posterior spinal fusion (PSF) using all-pedicle screw constructs has become the standard procedure in the treatment of adolescent idiopathic scoliosis (AIS). However, there have been several reports that all-pedicle screw constructs or the use of pedicle screws at the upper instrumented vertebrae (UIV) increases the incidence of proximal junctional kyphosis (PJK). We aimed to evaluate the impact of instrumentation type on the incidence of PJK following PSF for AIS. We performed a stratified random sampling from 3654 patients enrolled in a multicenter database of surgically treated AIS to obtain a representative sample from all Lenke types. Patients were then allocated into 3 groups based on the instrumentation type: all-pedicle screw (PS), hook at UIV with pedicle screws distally (HT), and hybrid constructs (HB). We measured proximal junctional angle (PJA) and defined PJK as PJA ≥ 10° and PJA progression of >10° at the final follow-up. Fifteen (4.3%) of 345 cases had PJK. PJK was significantly more common in PS (11%) compared with HB (1%) and HT (0%) (P < .001). PJK patients were similar to non-PJK patients regarding age, sex, curve type, UIV, and preoperative coronal Cobb angle. Thoracic kyphosis was signi...Continue Reading

References

Jun 5, 2013·Journal of Children's Orthopaedics·Bradley P JaquithDerek M Kelly
Jul 1, 2015·Spine Deformity·Elizabeth P NorheimSteven D Glassman
Jul 4, 2017·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Eleftherios ArchavlisAlf Giese
Jul 1, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Emmanuelle FerreroUNKNOWN Groupe d’Etude sur la Scoliose (GES)

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Citations

Feb 4, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Guodong WangJianmin Sun

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Methods Mentioned

BETA
dissection

Software Mentioned

Surgimap
SPSS Statistics

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