Evidence map›Paper›PMID 39522082›Full record

ArticleSpine deformity2025

Should the C7-T1 Junction Be Feared? The Effect of a T1 Upper Instrumented Vertebra on Development of Proximal Junctional Kyphosis.

Carlos Monroig-Rivera, Ingrid Okonta, Jennifer M Bauer, Amit Jain, Firoz Miyanji, Stefan Parent, Peter Newton, V Salil Upasani, Patrick Cahill, Daniel Sucato and 5 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Carlos Monroig-RiveraDepartment of Orthopedics, Scottish Rite for Children, 2222 Welborn St, Dallas, TX, 75219, USA.ORCID http://orcid.org/0000-0002-5147-2716
Ingrid OkontaSchool of Medicine, University of Louisville, Louisville, KY, USA.
Jennifer M BauerDept of Orthopedics and Sports Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Amit JainDepartment of Orthopaedic Surgery, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Firoz MiyanjiDepartment of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0002-3023-3660
Stefan ParentDepartment of Surgery, University of Montreal, Montreal, QC, Canada.ORCID http://orcid.org/0000-0002-4854-2816
Peter NewtonDivision Orthopedics and Scoliosis, Rady Children's Hospital, San Diego, CA, USA.ORCID http://orcid.org/0000-0001-9437-7973
V Salil UpasaniDivision Orthopedics and Scoliosis, Rady Children's Hospital, San Diego, CA, USA.
Patrick CahillDivision of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-7129-1007
Daniel SucatoDepartment of Orthopedics, Scottish Rite for Children, 2222 Welborn St, Dallas, TX, 75219, USA.ORCID http://orcid.org/0000-0003-3352-5551
Paul D SponsellerDepartment of Orthopaedic Surgery, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-2934-6374
Amer SamdaniDepartment of Pediatric Orthopedic Surgery, Shriners Children's Philadelphia, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-4206-610X
D'Marfeivel McLeanSchool of Medicine, Loma Linda University, Loma Linda, CA, USA.ORCID http://orcid.org/0009-0009-6721-9502
Jaysson T BrooksDepartment of Orthopedics, Scottish Rite for Children, 2222 Welborn St, Dallas, TX, 75219, USA. jaysson.brooks@tsrh.org.ORCID http://orcid.org/0000-0002-8523-1750
Harms Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.

methodsA query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up. Patients with a T1 UIV (n = 29) were compared to those with a T2 UIV (n = 58). PJK was defined as a proximal junctional angle (PJA) > 10 degrees.

resultsThere was no difference between the T1 and T2 UIV cohorts in preoperative T2-T12 kyphosis or pelvic incidence; however preoperatively, T1 UIV patients had a significantly decreased PJA at - 3° ± 4.5° as compared to T2 UIV patients 1.6° ± 6.5° (p = 0.0014). No patients with a T1 UIV experienced PJK at 5-years of follow-up, while 16% of patients with a T2 UIV experienced PJK (p = 0.025). No patients in the T2 UIV cohort required revision surgeries for their PJK. There was no difference found in total SRS22 scores, however at 5 years of follow-up, T2 UIV patients had better Pain domain scores (4.4 ± 0.6) vs T1 UIV patients (4.0 ± 0.6; p = 0.004).

conclusionWhile T1 is an uncommon UIV in AIS, at 5 years of follow-up, a T1 UIV did not result in PJK, nor did it result in a clinically significant change in patient-reported outcome scores.

Indexed as

Cervical VertebraeKyphosisPostoperative ComplicationsScoliosisSpinal FusionThoracic VertebraeAdolescentAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesTreatment OutcomeYoung AdultAdolescent idiopathic scoliosisPatient-reported outcomePosterior spinal fusionProximal junctional kyphosisUpper instrumented vertebra

Identifiers

PMID39522082

What OpenQuestion holds

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Registered trials

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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.