ArticleGlobal spine journal2021
A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine.
Article in Global spine journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Preoperative Thoracic Compensation is Associated With a Lower Risk of Proximal Junctional Kyphosis After Lower Thoracic Fusion for Adult Spinal Deformity.Global spine journal · 2026Article
- Impact of Preoperative Teriparatide Use on Proximal Junctional Kyphosis Prevention in Osteopenic/Osteoporotic Patients Undergoing Adult Spinal Deformity Surgery: A Propensity Score-Matched Study.Journal of clinical medicine · 2026Article
- Hybrid Posterior Fixation Incorporating Cervical Facet Fixation for the Treatment of Proximal Junctional Failure.Journal of orthopaedic case reports · 2026Article
- Comparison of Hook Fixation and Vertebroplasty for Prevention of Proximal Junctional Failure: A Retrospective Cohort Study.Global spine journal · 2026Article
- Lumbar Lateral Dislocation Fracture With Progressive Worsening of Trunk Tilt in Pisa Syndrome Associated With Parkinson's Disease.Case reports in orthopedics · 2026Article
- Concordance of the Fracture Risk Assessment Tool With and Without Bone Mineral Density and Its Role in Predicting Postoperative Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery.Neurosurgery practice · 2025Article
- Article
- Review
- The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review.North American Spine Society journal · 2024Review
- Is It Possible for Patients with Early Distal Junctional Kyphosis following Adult Cervical Deformity Corrective Surgery to Achieve Similar Outcomes to Their Unaffected Counterparts? An Analysis of Recovery Kinetics.Journal of clinical medicine · 2024Article
- Predicting Mechanical Failure Following Cervical Deformity Surgery: A Composite Score Integrating Age-Adjusted Cervical Alignment Targets.Global spine journal · 2023Article
- Patient Optimization for the Prevention of Proximal Junctional Kyphosis.International journal of spine surgery · 2023Article
- Proximal Junctional Kyphosis or Failure After Adult Spinal Deformity Surgery - Review of Risk Factors and Its Prevention.Neurospine · 2023Article
- Comparison of thoracolumbar versus non-thoracolumbar osteoporotic vertebral compression fractures in risk factors, vertebral compression degree and pre-hospital back pain.Journal of orthopaedic surgery and research · 2023Article
- Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis.Global spine journal · 2023Article
- Avoiding Spinal Implant Failures in Osteoporotic Patients: A Narrative Review.Global spine journal · 2023Article
- Delayed stenosis associated with sublaminar band placement in the thoracic spine for proximal junctional kyphosis.Surgical neurology international · 2023Article
- A Review of Strategies to Improve Biomechanical Fixation in the Cervical Spine.Global spine journal · 2022Article
- Compensatory mechanisms recruited against proximal junctional kyphosis by patients instrumented from the thoracolumbar junction to the iliac.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 · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review.
objectivesProximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-known complications after long-segment fusions in the thoracolumbar spine of osteoporotic patients. Recent advances in anti-resorptive and anabolic medications, instrumentation, surgical technique, and cement augmentation have all aided in the avoidance of junctional kyphosis. In this article, current literature on the prevention of PJK and PJF in the osteoporotic spine is reviewed.
methodsA systematic literature review was conducted using the PubMed/MEDLINE and Embase databases in order to search for the current preventive treatment methods for PJK and PJF published in the literature (1985 to present). Inclusion criteria included (1) published in English, (2) at least 1-year mean and median follow-up, (3) preoperative diagnosis of osteoporosis, (4) at least 3 levels instrumented, and (5) studies of medical treatment or surgical techniques for prevention of junctional kyphosis.
resultsThe review of the literature yielded 7 studies with low levels of evidence ranging from level II to IV. Treatment strategies reviewed addressed prophylaxis against ligamentous failure, adjacent vertebral compression fracture, and/or bone-implant interface failure. This includes studies on the effect of osteoporosis medication, cement augmentation, multi-rod constructs, and posterior-tension band supplementation. The role of perioperative teriparatide therapy maintains the highest level of evidence.
conclusionsPerioperative teriparatide therapy represents the strongest evidence for preventive treatment, and further clinical trials are warranted. Use of cement augmentation, sublaminar tethers, and multi-rod constructs have low or insufficient evidence for recommendations. Future guidelines for adult spinal deformity correction may consider bone mineral density-adjusted alignment goals.
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