Proximal Junctional Kyphosis in Degenerative Sagittal Deformity after Under- and Overcorrection of Lumbar Lordosis: Does Overcorrection of Lumbar Lordosis Instigate PJK?

Spine
Sang-Kyu ImMan Ho Kim

Abstract

Retrospective study. To analyze proximal junctional kyphosis (PJK) occurrence and surgical outcomes according to degree of lumbar lordosis (LL) correction relative to pelvic incidence (PI). In addition, risk factors of PJK including LL and sagittal vertical axis (SVA) correction were investigated. PJK is a common complication after adult spinal deformity (ASD) surgery, and many factors are known to be associated with PJK. However, the effect of degree of LL correction on PJK occurrence is not fully understood. 83 degenerative sagittal imbalance patients treated with deformity correction and long instrumented fusion to the sacrum with a minimum follow-up of 2 years were studied. Patients were divided into three groups according to their postoperative LL angle relative to PI using the SRS-Schwab classification: Group A (undercorrection, PI-LL> 10°), Group B (ideal correction, -10°<PI-LL≤10°), and Group C (overcorrection, PI-LL≤-10°). Prevalence, classification, and period of PJK occurrence were compared, and radiographic and clinical outcomes were analyzed. In addition, risk factors for PJK were evaluated. Overall PJK prevalence was 36.1% (30/83), and ratio of optimal SVA at postoperative and last follow-up were significantly hig...Continue Reading

References

Jun 18, 1998·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·J LegayeC Marty
Jul 31, 2013·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·Chong Suh LeeSeong Kee Shin
May 27, 2015·The Spine Journal : Official Journal of the North American Spine Society·Micah W SmithDarrel S Brodke
Feb 18, 2016·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·Jung-Hee LeeHyuk Jung
Jun 25, 2016·Asian Spine Journal·Jaewon Lee, Ye-Soo Park

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