ArticleBMC musculoskeletal disorders2022
Unmatched rod contouring at the proximal end predisposes to occurrence of junctional kyphosis in early-onset scoliosis patients undergoing traditional growing rods treatment.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Outcomes of retained growing rods without final fusion in early-onset scoliosis: What happened after graduation?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
- Proximal junctional kyphosis in distraction-based growth-friendly treatment: Definition, risk factors, and timeline.Journal of children's orthopaedics · 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
- Risk Factor Analysis for Proximal Junctional Kyphosis in Neuromuscular Scoliosis: A Single-Center Study.Journal of clinical medicine · 2025Article
- Excessive posterior placement of upper instrumented vertebra relative to lower instrumented vertebra as a predictor of proximal junction kyphosis after selective spinal fusion for adolescent idiopathic scoliosis Lenke type 5C curves.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 · 2024Article
- Prevention of Proximal Junctional Kyphosis Using Proximal Fixation Techniques.International journal of spine surgery · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
STUDY
designA retrospective case series.
objectiveTo investigate whether unmatched rod contouring at the proximal end predisposed to the occurrence of proximal junctional kyphosis (PJK) in early-onset scoliosis (EOS) patients after traditional growing rods (TGR) treatment. TGR treatment has become a mainstay of treatment for EOS patients. PJK is one of the most common alignment-related complications.
methodsA consecutive series of EOS patients who had undergone TGR treatment were retrospectively reviewed. They were divided into PJK and non-PJK groups according to the occurrence of PJK or not. Demographic data, surgical strategies, and radiographic parameters were recorded and compared between groups. Proximal junctional angle (PJA) was defined as the angle between the caudal endplate of the UIV and the cephalad endplate of the second supradjacent vertebra above the UIV, while proximal rod contouring angle (PRCA) was defined as the angle of proximal rod contouring, which was represented by the angle between the cephalad endplate of the UIV and the caudal endplate of the second vertebra caudal to the UIV. Unmatched proximal rod contouring was regarded if the postoperative PRCA-PJA difference was greater than 5°.
resultsThis study finally included 73 patients. The mean age at the index surgery was 6.5 ± 2.2 years (range, 2-10 years). Mean follow-up lasted 5.0 ± 1.7 years (range, 2-9 years). They received mean 4.6 ± 1.6 lengthening procedures. There were 13 patients who were observed with PJK (18%). In comparison with the non-PJK group, the PJK group showed a larger preoperative major curve (82 ± 21° vs 70 ± 17°, P = 0.041) and global kyphosis (57 ± 6° vs. 44 ± 15°, P = 0.044). In addition, the PJK group had significantly larger postoperative PJA (10 ± 3 vs. 5 ± 3, P<0.001) and greater postoperative PJA-PRCA (6 ± 3 vs. 3 ± 3, P = 0.031). The proportion of patients with unmatched proximal rod contouring in PJK group was significantly higher than that in the non-PJK group (69% vs. 25%). Multiple logistic regression showed that preoperative GK>50°, postoperative PJA>10 and postoperative unmatched proximal rod contouring were the risk factors in predicting PJK after TGR treatment.
conclusionApproximately 18% EOS patients experienced PJK after TGR treatment. Unmatched proximal rod contouring may be an independent risk factor of PJK occurrence, in addition to greater preoperative GK and larger postoperative PJA. LEVEL OF EVIDENCE: 3:
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