SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016
Incidence and risk factors for proximal junctional kyphosis: a meta-analysis.
Synthesis in 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, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
73 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Incidence of neurological deficits following proximal junctional kyphosis or failure in adult spinal deformity surgery: a systematic review and meta-analysis.Spine deformity · 2025Pooled it
- The predictive power of the Roussouly classification on mechanical complications after surgery for adult spinal deformity: systematic review and meta-analysis.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 · 2025Pooled it
- Assessing the predictive power of the GAP score on mechanical complications: a comprehensive systematic review and meta-analysis.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 · 2024Pooled it
- Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: A systematic review and meta-analysis.Acta orthopaedica et traumatologica turcica · 2022Pooled it
- Incidence and risk factors of proximal junctional kyphosis after internal fixation for adult spinal deformity: a systematic evaluation and meta-analysis.Neurosurgical review · 2021Pooled it
- Characteristics and risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: a systematic review and meta-analysis.Neurosurgical review · 2019Pooled it
- Pooled it
- Radiographic predictors of proximal junctional kyphosis after adult spinal deformity surgery: a systematic review and meta-analysis.Spine deformity · 2026Article
- The relative contribution of discs and vertebral bodies to thoracic kyphosis in healthy volunteers.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 · 2026Article
- CT-Based Analysis of Rod Trace Length Changes During Posterior Spinal Correction in Adult Spinal Deformity.Journal of clinical medicine · 2026Article
- Standardized translaminar spinal tethering to prevent proximal junctional kyphosis in adult spinal deformity correction surgery.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 · 2026Article
- Predictive factors for osteoporosis in adult spinal deformity patients.Spine deformity · 2025Article
- Preoperative cervical alignment can affect the occurrence of proximal junctional kyphosis in patients with adolescent idiopathic scoliosis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- The relationship between postoperative proximal junctional kyphosis and MRI-based pedicle bone quality scores in thoracic adolescent idiopathic scoliosis.BMC surgery · 2025Article
- Late Complications and Adverse Events in Adult Deformity Surgery: A Narrative Review of Event Types, Prevalence, and Information Gaps.Global spine journal · 2025Article
- Impact of kyphosis exceeding 30° on lumbar spine in patients with post-traumatic kyphosis.Scientific reports · 2025Article
- A comprehensive review of risk factors and prevention strategies: how to minimize mechanical complications in corrective surgery for adult spinal deformity.Asian spine journal · 2025Article
- Risk Factor Analysis for Proximal Junctional Kyphosis in Neuromuscular Scoliosis: A Single-Center Study.Journal of clinical medicine · 2025Article
- Article
- Factors associated with rod fracture following surgery for adult spinal deformity: a single-center retrospective study.Spine deformity · 2025Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo analyse the incidence and risk factors associated with proximal junctional kyphosis (PJK) following spinal fusion, we collect relative statistics from the articles on PJK and perform a meta-analysis.
methodsAn extensive search of literature was performed in PubMed, Embase, and The Cochrane Library (up to April 2015). The following risk factors were extracted: age at surgery, gender, combined anterior-posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation, thoracoplasty, fusion to sacrum (S1), preoperative thoracic kyphosis angle (T5-T12) >40°, bone mineral density (BMD) and preoperative to postoperative sagittal vertical axis (SVA difference) >5 cm. Data analysis was conducted with RevMan 5.3 and STATA 12.0.
resultsA total of 14 unique studies including 2215 patients were included in the final analyses. The pooled analysis showed that there were significant difference in age at surgery >55 years old (OR 2.19, 95 % CI 1.36-3.53, p = 0.001), fusion to S1 (OR 2.12, 95 % CI 1.57-2.87, p < 0.001), T5-T12 >40° (OR 2.68, 95 % CI 1.73-4.13, p < 0.001), low BMD (OR 2.37, 95 % CI 1.45-3.87, p < 0.001) and SVA difference >5 cm (OR 2.53, 95 % CI 1.24-5.18, p = 0.01). However, there was no significant difference in gender (OR 0.98, 95 % CI 0.74-1.30, p = 0.87), combined anterior-posterior surgery (OR 1.55, 95 % CI 0.98-2.46, p = 0.06), use of pedicle screw at top of construct (OR 1.55, 95 % CI 0.67-3.59, p = 0.30), hybrid instrumentation (OR 1.31, 95 % CI 0.92-1.87, p = 0.13) and thoracoplasty (OR 1.55, 95 % CI 0.89-2.72, p = 0.13). The incidence of PJK following spinal fusion was 30 % (ranged from 17 to 62 %) based on the 14 studies.
conclusionsThe results of our meta-analysis suggest that age at surgery >55 years, fusion to S1, T5-T12 >40°, low BMD and SVA difference >5 cm are risk factors for PJK. However, gender, combined anterior-posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation and thoracoplasty are not associated with PJK.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.