Ligament augmentation for prevention of proximal junctional kyphosis and proximal junctional failure in adult spinal deformity

Journal of Neurosurgery. Spine
Michael M SafaeeChristopher Ames

Abstract

OBJECTIVE Proximal junctional kyphosis (PJK) is a well-recognized, yet incompletely defined, complication of adult spinal deformity surgery. There is no standardized definition for PJK, but most studies describe PJK as an increase in the proximal junctional angle (PJA) of greater than 10°-20°. Ligament augmentation is a novel strategy for PJK reduction that provides strength to the upper instrumented vertebra (UIV) and adjacent segments while also reducing junctional stress at those levels. METHODS In this study, ligament augmentation was used in a consecutive series of adult spinal deformity patients at a single institution. Patient demographics, including age; sex; indication for surgery; revision surgery; surgical approach; and use of 3-column osteotomies, vertebroplasty, or hook fixation at the UIV, were collected. The PJA was measured preoperatively and at last follow-up using 36-inch radiographs. Data on change in PJA and need for revision surgery were collected. Univariate and multivariate analyses were performed to identify factors associated with change in PJA and proximal junctional failure (PJF), defined as PJK requiring surgical correction. RESULTS A total of 200 consecutive patients were included: 100 patients befo...Continue Reading

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Citations

Aug 4, 2018·Journal of Neurosurgery. Spine·Thomas J BuellShay Bess
May 20, 2020·JBJS Reviews·Shyam A PatelJeffrey A Rihn
Jan 16, 2020·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·Francisco Rodriguez-FontanVikas V Patel
Jan 26, 2021·The Spine Journal : Official Journal of the North American Spine Society·Remco J P DoodkortePaul C Willems
May 20, 2020·JBJS Reviews·Alexander RosinskiDimitriy Kondrashov
May 18, 2021·Seminars in Plastic Surgery·Marc PrablekDavid S Xu
Oct 30, 2021·Journal of Orthopaedic Surgery·Justin K ScheerChristopher P Ames

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