Evidence map›Paper›PMID 39107091›Full record

ArticleInternational journal of spine surgery2024

Risk Factors for Recurrent Proximal Junctional Failure Following Adult Spinal Deformity Surgery: Analysis of 60 Patients Undergoing Fusion Extension Surgery for Proximal Junctional Failure.

Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Chong-Suh Lee, Hyun-Jun Kim

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Article in International journal of spine surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Se-Jun ParkDepartment of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jin-Sung ParkDepartment of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Dong-Ho KangDepartment of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Chong-Suh LeeDepartment of Orthopedic Surgery, Haeundae Bumin Hospital, Busan, South Korea.
Hyun-Jun KimDepartment of Orthopedic Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri-si, Gyeonggi Province, South Korea hyunjun89.kim@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite numerous studies identifying risk factors for proximal junctional failure (PJF), risk factors for recurrent PJF (R-PJF) are still not well established. Therefore, we aimed to identify the risk factors for R-PJF following adult spinal deformity (ASD) surgery.

methodsAmong 479 patients who underwent ≥5-level fusion surgery for ASD, the focus was on those who experienced R-PJF at any time or did not experience R-PJF during a follow-up duration of ≥1 year. PJF was defined as a proximal junctional angle (PJA) ≥28° plus a difference in PJA ≥22° or performance of revision surgery regardless of PJA degree. The patients were divided into 2 groups according to R-PJF development: no R-PJF and R-PJF groups. Risk factors were evaluated focusing on patient, surgical, and radiographic factors at the index surgery as well as at the revision surgery.

resultsOf the 60 patients in the final study cohort, 24 (40%) experienced R-PJF. Significant risk factors included greater postoperative sagittal vertical axis (OR = 1.044), overcorrection relative to age-adjusted pelvic incidence-lumbar lordosis (PI-LL; OR = 7.794) at the index surgery, a greater total sum of the proximal junctional kyphosis severity scale (OR = 1.145), and no use of the upper instrumented vertebra cement (OR = 5.494) at the revision surgery.

conclusionsWe revealed that the greater postoperative sagittal vertical axis and overcorrection relative to age-adjusted pelvic incidence-lumbar lordosis at the index surgery, a greater proximal junctional kyphosis severity scale score, and no use of upper instrumented vertebra cement at the revision surgery were significant risk factors for R-PJF. CLINICAL RELEVANCE: To reduce the risk of R-PJF after ASD surgery, avoiding under- and overcorrection during the initial surgery is recommended. Additionally, close assessment of the severity of PJF with timely intervention is crucial, and cement augmentation should be considered during revision surgery. LEVEL OF EVIDENCE: 3:

Indexed as

Cement augmentationOvercorrectionProximal junctional kyphosis severity scaleRecurrent proximal junctional failureRisk factorsUndercorrection

Identifiers

PMID39107091
PMCPMC11616410

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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.