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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...

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Autores principales: Lee, Byung-Jou, Bae, Sung Soo, Choi, Ho Young, Park, Jin Hoon, Hyun, Seung-Jae, Jo, Dae Jean, Cho, Yongjae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Spinal Neurosurgery Society 2023
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.
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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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