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Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment

Proximal junctional kyphosis (PJK) is a common radiographic finding after long spinal fusion. A number of studies on the causes, risk factors, prevention, and treatment of PJK have been conducted. However, no clear definition of PJK has been established. In this paper, we aimed to clarify the diagno...

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Autores principales: Lee, Jaewon, Park, Ye-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917781/
https://www.ncbi.nlm.nih.gov/pubmed/27340542
http://dx.doi.org/10.4184/asj.2016.10.3.593
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author Lee, Jaewon
Park, Ye-Soo
author_facet Lee, Jaewon
Park, Ye-Soo
author_sort Lee, Jaewon
collection PubMed
description Proximal junctional kyphosis (PJK) is a common radiographic finding after long spinal fusion. A number of studies on the causes, risk factors, prevention, and treatment of PJK have been conducted. However, no clear definition of PJK has been established. In this paper, we aimed to clarify the diagnosis, prevention, and treatment of PJK by reviewing relevant papers that have been published to date. A literature search was conducted on PubMed using "proximal junctional", "proximal junctional kyphosis", and "proximal junctional failure" as search keywords. Only studies that were published in English were included in this study. The incidence of PJK ranges from 5% to 46%, and it has been reported that 66% of cases occur 3 months after surgery and approximately 80% occur within 18 months. A number of studies have reported that there is no significantly different clinical outcome between PJK patients and non-PJK patients. One study showed that PJK patients expressed more pain than non-PJK patients. However, recent studies focused on proximal junctional failure (PJF), which is accepted as a severe form of PJK. PJF showed significant adverse impact in clinical aspect such as pain, neurologic deficit, ambulatory difficulties, and social isolation. Numerous previous studies have identified various risk factors and reported on the treatment and prevention of PJK. Based on these studies, we determined the clinical significance and impact of PJK. In addition, it is important to find a strategic approach to the proper treatment of PJK.
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spelling pubmed-49177812016-06-23 Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment Lee, Jaewon Park, Ye-Soo Asian Spine J Review Article Proximal junctional kyphosis (PJK) is a common radiographic finding after long spinal fusion. A number of studies on the causes, risk factors, prevention, and treatment of PJK have been conducted. However, no clear definition of PJK has been established. In this paper, we aimed to clarify the diagnosis, prevention, and treatment of PJK by reviewing relevant papers that have been published to date. A literature search was conducted on PubMed using "proximal junctional", "proximal junctional kyphosis", and "proximal junctional failure" as search keywords. Only studies that were published in English were included in this study. The incidence of PJK ranges from 5% to 46%, and it has been reported that 66% of cases occur 3 months after surgery and approximately 80% occur within 18 months. A number of studies have reported that there is no significantly different clinical outcome between PJK patients and non-PJK patients. One study showed that PJK patients expressed more pain than non-PJK patients. However, recent studies focused on proximal junctional failure (PJF), which is accepted as a severe form of PJK. PJF showed significant adverse impact in clinical aspect such as pain, neurologic deficit, ambulatory difficulties, and social isolation. Numerous previous studies have identified various risk factors and reported on the treatment and prevention of PJK. Based on these studies, we determined the clinical significance and impact of PJK. In addition, it is important to find a strategic approach to the proper treatment of PJK. Korean Society of Spine Surgery 2016-06 2016-06-16 /pmc/articles/PMC4917781/ /pubmed/27340542 http://dx.doi.org/10.4184/asj.2016.10.3.593 Text en Copyright © 2016 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Lee, Jaewon
Park, Ye-Soo
Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title_full Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title_fullStr Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title_full_unstemmed Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title_short Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment
title_sort proximal junctional kyphosis: diagnosis, pathogenesis, and treatment
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917781/
https://www.ncbi.nlm.nih.gov/pubmed/27340542
http://dx.doi.org/10.4184/asj.2016.10.3.593
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