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Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention
Proximal junction kyphosis (PJK) is a common imaging finding after long-level fusion, and proximal junctional failure (PJF) is an aggravated form of the progressive disease spectrum of PJK. This includes vertebral fracture of upper instrumented vertebra (UIV) or UIV+1, instability between UIV and UI...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Spinal Neurosurgery Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562224/ https://www.ncbi.nlm.nih.gov/pubmed/37798982 http://dx.doi.org/10.14245/ns.2346476.238 |
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author | Lee, Byung-Jou Bae, Sung Soo Choi, Ho Young Park, Jin Hoon Hyun, Seung-Jae Jo, Dae Jean Cho, Yongjae |
author_facet | Lee, Byung-Jou Bae, Sung Soo Choi, Ho Young Park, Jin Hoon Hyun, Seung-Jae Jo, Dae Jean Cho, Yongjae |
author_sort | Lee, Byung-Jou |
collection | PubMed |
description | Proximal junction kyphosis (PJK) is a common imaging finding after long-level fusion, and proximal junctional failure (PJF) is an aggravated form of the progressive disease spectrum of PJK. This includes vertebral fracture of upper instrumented vertebra (UIV) or UIV+1, instability between UIV and UIV+1, neurological deterioration requiring surgery. Many studies have reported on PJK and PJF after long segment instrumentation for adult spinal deformity (ASD). In particular, for spine deformity surgeons, risk factors and prevention strategies of PJK and PJF are very important to minimize reoperation. Therefore, this review aims to help reduce the occurrence of PJK and PJF by updating the latest contents of PJK and PJF by 2023, focusing on the risk factors and prevention strategies of PJK and PJF. We conducted a search on multiple database for articles published until February 2023 using the search keywords “proximal junctional kyphosis,” “proximal junctional failure,” “proximal junctional disease,” and “adult spinal deformity.” Finally, 103 papers were included in this study. Numerous factors have been suggested as potential risks for the development of PJK and PJF, including a high body mass index, inadequate postoperative sagittal balance and overcorrection, advanced age, pelvic instrumentation, and osteoporosis. Recently, with the increasing elderly population, sarcopenia has been emphasized. The quality and quantity of muscle in the surgical site have been suggested as new risk factor. Therefore, spine surgeon should understand the pathophysiology of PJK and PJF, as well as individual risk factors, in order to develop appropriate prevention strategies for each patient. |
format | Online Article Text |
id | pubmed-10562224 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Korean Spinal Neurosurgery Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-105622242023-10-11 Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention Lee, Byung-Jou Bae, Sung Soo Choi, Ho Young Park, Jin Hoon Hyun, Seung-Jae Jo, Dae Jean Cho, Yongjae Neurospine Review Article Proximal junction kyphosis (PJK) is a common imaging finding after long-level fusion, and proximal junctional failure (PJF) is an aggravated form of the progressive disease spectrum of PJK. This includes vertebral fracture of upper instrumented vertebra (UIV) or UIV+1, instability between UIV and UIV+1, neurological deterioration requiring surgery. Many studies have reported on PJK and PJF after long segment instrumentation for adult spinal deformity (ASD). In particular, for spine deformity surgeons, risk factors and prevention strategies of PJK and PJF are very important to minimize reoperation. Therefore, this review aims to help reduce the occurrence of PJK and PJF by updating the latest contents of PJK and PJF by 2023, focusing on the risk factors and prevention strategies of PJK and PJF. We conducted a search on multiple database for articles published until February 2023 using the search keywords “proximal junctional kyphosis,” “proximal junctional failure,” “proximal junctional disease,” and “adult spinal deformity.” Finally, 103 papers were included in this study. Numerous factors have been suggested as potential risks for the development of PJK and PJF, including a high body mass index, inadequate postoperative sagittal balance and overcorrection, advanced age, pelvic instrumentation, and osteoporosis. Recently, with the increasing elderly population, sarcopenia has been emphasized. The quality and quantity of muscle in the surgical site have been suggested as new risk factor. Therefore, spine surgeon should understand the pathophysiology of PJK and PJF, as well as individual risk factors, in order to develop appropriate prevention strategies for each patient. Korean Spinal Neurosurgery Society 2023-09 2023-09-30 /pmc/articles/PMC10562224/ /pubmed/37798982 http://dx.doi.org/10.14245/ns.2346476.238 Text en Copyright © 2023 by the Korean Spinal Neurosurgery Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Lee, Byung-Jou Bae, Sung Soo Choi, Ho Young Park, Jin Hoon Hyun, Seung-Jae Jo, Dae Jean Cho, Yongjae Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title | Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title_full | Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title_fullStr | Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title_full_unstemmed | Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title_short | Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention |
title_sort | proximal junctional kyphosis or failure after adult spinal deformity surgery - review of risk factors and its prevention |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562224/ https://www.ncbi.nlm.nih.gov/pubmed/37798982 http://dx.doi.org/10.14245/ns.2346476.238 |
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