ArticleJournal of orthopaedic surgery and research2022
Proximal junctional kyphosis is a compensation for post-operative negative C2-FH in ASD patients: a cross-sectional study.
Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Article
- Adolescent scoliosis in autism spectrum disorder: is it idiopathic or syndromic??Journal of orthopaedic surgery and research · 2025Article
- Novel radiological predictors for the progression of proximal junctional kyphosis in osteoporotic vertebral compression fracture with kyphosis following posterior corrective surgery.Spine deformity · 2025Article
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7 authors.
Funding
Abstract
backgroundRecent studies have found that C2-FH is close to 0 cm in both standing and sitting position for asymptomatic adults. We hypothesize that the thoracic spine may compensate with PJK when the immediate post-operative C2-FH was not ideally restored in adult spinal deformity (ASD).
methodsThe inclusion criteria were as follows: ASD patients over 45 years old; Cobb angle > 30°; with posterior spinal correction surgery; at least 2 years follow-up. C2-FH was defined as the distance between the femoral heads to the C2 vertical line. All participants were divided into two groups according to the occurrence of PJK at the last follow-up: PJK group and non-PJK group.
results68 ASD patients, with a minimum follow-up of 2.5 years, were included. PJK was found in 24 patients (35.3%) while the rest 44 patients remained no sagittal malalignment. Immediately post-operative C2-FH showed significant difference between PJK group and non-PJK group (p = 0.015). However, at the last follow-up, C2-FH showed no significant difference between PJK and non-PJK group and the mean value of C2-FH in both groups was approximately - 1 cm, indicating that ASD patients could develop various compensatory mechanisms to maintain sagittal global balance. The AUC was 0.84 (95%CI 0.68-0.97), indicating the well effectiveness of ROC curve and cut-off value in predicting occurrence of PJK in ASD patients. Based on the ROC curve, the optimal cut-off value of C2-FH as indicators for occurrence of PJK was - 42.3 mm.
conclusionImmediate postoperative negative global malalignment (C2-FH < - 42.3 mm) may predict proximal junctional kyphosis in ASD patients. The normal value of C2-FH, - 1 cm, may be the target of global sagittal compensation, and PJK is a compensatory mechanism.
trial registration2021-LCYJ-DBZ-05, 2021.07, Retrospective study.
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