SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Distal junctional failure in posterior cervical and cervicothoracic fusion: A systematic review and meta-analysis of associated factors.
Synthesis 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.
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.
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.
Who cites it
1 citing paper in PubMed.
- Role of T2 pedicle subtraction osteotomy in rigid cervicothoracic sagittal imbalance correction: A case series with technical details.Journal of craniovertebral junction & spineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDistal junctional kyphosis (DJK) is a significant complication following posterior cervical or cervicothoracic fusion. Despite the increasing number of these procedures, the factors associated with DJK remain underexplored, particularly compared to proximal junctional kyphosis. This systematic review and meta-analysis aimed to identify key factors associated with DJK and provide actionable recommendations for its prevention.
methodsA comprehensive search of PubMed, Scopus, Embase, and Web of Science was conducted to identify case-control and cohort studies reporting on factors associated with DJK in adult patients undergoing posterior cervical or cervicothoracic fusion. Data on demographics, radiographic parameters, and surgical factors were extracted. Meta-analysis was performed using a random-effects model, with odds ratios (OR) and standardized mean differences (SMD) calculated for significant variables.
resultsDJK occurred in 15.2% of patients across the included studies. Significant associated factors included osteoporosis, preoperative cervical kyphosis greater than 3.4°, preoperative C2-C7 sagittal vertical axis (cSVA) exceeding 30 mm, postoperative residual cSVA exceeding 32 mm, a T1 slope change greater than 6 degrees, fusions involving more than five levels, and selecting the lowest instrumented vertebra (LIV) in the lower thoracic or thoracolumbar regions.
conclusionOptimizing sagittal alignment, addressing osteoporosis, and carefully selecting the lowest instrumented vertebra may help reduce DJK incidence in posterior cervical and cervicothoracic fusion surgeries. Future prospective studies are needed to refine prevention strategies and improve patient outcomes.
Indexed as
Identifiers
40853457What OpenQuestion holds
Registered trials
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.