ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Standardized translaminar spinal tethering to prevent proximal junctional kyphosis in adult spinal deformity correction 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, 2026. 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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Abstract
purposeThis study evaluated whether standardized proximal translaminar spinal tethering at the upper instrumented vertebra (UIV) + 1 and UIV + 2 reduces the incidence of proximal junctional kyphosis (PJK) and the need for revision surgery in patients undergoing thoraco-lumbar deformity correction for adult spinal deformity (ASD).
methodsA retrospective cohort study was conducted on 59 adult patients who underwent thoraco-lumbar deformity correction surgery between October 2019 and August 2023. Patients were categorized into tethered (T) and non-tethered (NT) groups. Radiographic measurements were performed preoperatively, early postoperatively (≤ 3 months), and late postoperatively (> 3 months) to assess PJK, defined as a proximal junctional angle (PJA) ≥ 10° and ≥ 10° greater than the corresponding preoperative measurement.
resultsOverall, 18 patients (30.5%) developed PJK, with no significant difference between tethered (12%) and non-tethered (20.5%) patients within the first 3 months (p = 0.384). However, at late follow-up, the PJK rate was significantly higher in non-tethered (41.1%) compared to tethered (16%) patients (p = 0.037), with non-tethered patients being 3.67 times more likely to develop PJK (95% CI = 1.03–13.07). Kaplan–Meier analysis showed a significant reduction in time-dependent PJK development for tethered patients (p = 0.027). Revision surgery was required in 11.8% of non-tethered patients compared to 4% of tethered patients (p = 0.289).
conclusionProximal translaminar tethering at UIV + 1 and UIV + 2 effectively reduces the incidence of PJK in patients undergoing thoraco-lumbar deformity correction. However, the effect on surgical revision rates due to PJK remains unclear, warranting further long-term prospective studies.
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