ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021
Proximal junctional kyphosis is a rebalancing spinal phenomenon due to insufficient postoperative thoracic kyphosis after adolescent idiopathic scoliosis surgery.
Article 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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incidence and risk factors of proximal junctional kyphosis in adolescent idiopathic scoliosis after correction surgery: a meta-analysis and systematic review.Journal of orthopaedic surgery and research · 2024Pooled it
- Normal spino-pelvic alignment in healthy adolescents: defining the PI-SS relationship and laying the foundations for pre-operative sagittal planning.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
- Sagittal spinal alignment in adolescent idiopathic scoliosis: a narrative review of pre- and post-treatment characteristics.EFORT open reviews · 2026Review
- Sagittal Profiles and Their Reciprocal Changes Manifesting in Proximal Junctional Kyphosis Following Deformity Correction in Adolescent Idiopathic Scoliosis.Global spine journal · 2026Article
- Global and segmental thoracolumbar sagittal alignment in adolescent idiopathic scoliosis compared to normal individuals.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
- 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
- Sagittal alignment correction of adolescent idiopathic scoliosis using patient-specific rods.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 · 2025Article
- Risk Factor Analysis for Proximal Junctional Kyphosis in Neuromuscular Scoliosis: A Single-Center Study.Journal of clinical medicine · 2025Article
- Curve progression following selective and nonselective spinal fusion for adolescent idiopathic scoliosis: are selective fusions stable?Spine deformity · 2025Article
- Spontaneous multilevel lumbar pediculolysis associated with spondylolysis: a rare case and review of the literature.BMC musculoskeletal disorders · 2024Review
- Long-term outcomes of spinal fusion in adolescent idiopathic scoliosis: a literature review.European journal of medical research · 2024Review
- Posterior Correction and Fusion Using a 4D Anatomical Spinal Reconstruction Technique Improves Postural Stability Under the Eye-Closed Condition in Patients with Adolescent Idiopathic Scoliosis.Journal of clinical medicine · 2024Article
- Can Lumbopelvic Parameters Be Used to Predict Thoracic Kyphosis at all Ages? A National Cross-Sectional Study.Global spine journal · 2024Article
- Sagittal Balance Parameters and Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis.Journal of clinical medicine · 2024Review
- Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review.Children (Basel, Switzerland) · 2024Review
- Systematic review and meta-analysis for the proximal junctional kyphosis in adolescent idiopathic scoliosis.Frontiers in pediatrics · 2024Review
- Vertebral bone quality score as a novel predictor of proximal junctional kyphosis after thoracic adolescent idiopathic scoliosis 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 · 2023Article
- How Does Gravity Influence the Distribution of Lordosis in Patients With Sagittal Malalignment?Global spine journal · 2023Article
- Postoperative proximal junctional kyphosis correlated with thoracic inlet angle in Lenke 5c adolescent idiopathic scoliosis patients following posterior surgery.BMC musculoskeletal disorders · 2022Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMany authors tried to explain proximal junctional kyphosis (PJK) after adolescent idiopathic scoliosis (AIS) surgery by looking for risk factors. Latest publications focus on sagittal alignment. Each healthy adolescent has a specific thoracic kyphosis (TK) depending on their pelvic parameters and lumbar lordosis (LL). The objective of this work is to determine if the difference between TK at follow-up (TKFU) and the patient-specific TK (PSTK) plays a role in PJK occurrence after AIS surgery. The secondary objective was to find other risk factors.
methodsWe analyzed retrospectively 570 thoracic AIS who underwent a posterior thoracic fusion from nine centers. The series was separated in two groups: with and without PJK. PSTK was calculated with the formula PSTK = 2(PT + LL-PI). TK Gap was the difference between TKFU and PSTK. Logistic regression was utilized to test the impact of TK Gap and other known risk factors on PJK occurrence.
resultsUnivariate analysis showed 15 factors significantly different between the groups. In a multivariate analysis, three factors had a strong significant influence on PJK: TKFU, TK Gain and TK Gap. Four additional factors affected the rate of PJK: Posterior translation on two rods, preoperative TK, preoperative LL and number of instrumented vertebrae.
conclusionPJK is related to the insufficient TK at follow-up, compared to the specific TK that every patient should have according to their pelvic parameters. PJK incidence is significantly reduced by a strong gain in TK and a thoracic selective fusion which leaves the proximal lumbar vertebrae free. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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