TY - JOUR
T1 - Proximal junctional kyphosis prevention strategies
T2 - A video technique guide
AU - Safaee, Michael M.
AU - Osorio, Joseph A.
AU - Verma, Kushagra
AU - Bess, Shay
AU - Shaffrey, Christopher I.
AU - Smith, Justin S.
AU - Hart, Robert
AU - Deviren, Vedat
AU - Ames, Christopher P.
N1 - Publisher Copyright:
© 2017 by the Congress of Neurological Surgeons.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - BACKGROUND: Proximal junctional kyphosis (PJK) is a well-recognized complication in patients undergoing posterior instrumented fusion procedures for adult spinal deformity. Strategies that reduce rates of PJK have the potential to improve the safety of these operations and decrease cost by eliminating the need for revision surgery.OBJECTIVE: To present a set of surgical techniques that can decrease rates of PJK in adults undergoing surgery for spinal deformity.METHODS: We summarize the use of vertebroplasty, transverse process hooks, terminal rod contouring, and ligament augmentation as means to reduce rates of PJK.RESULTS: We present PJK prevention strategies and a video technique guide that are safe, technically feasible, and add minimal operative time to these surgical procedures. When applied to appropriate high-risk patients, these techniques have the potential to dramatically reduce rates of PJK, which improves quality of life and decreases the cost associated with this treating adult spinal deformity.CONCLUSION: PJK prevention strategies represent a critical area for improvement in surgery for adult spinal deformity. We present a summary of techniques that are safe, feasible, and add minimal time to the overall procedure. These techniques warrant investigation in a thoughtful, prospective manner, but are supported by existing data and compelling biomechanical rationale. Our hope is that these strategies can be applied, particularly in high-risk patients, to help reduce rates of PJK.
AB - BACKGROUND: Proximal junctional kyphosis (PJK) is a well-recognized complication in patients undergoing posterior instrumented fusion procedures for adult spinal deformity. Strategies that reduce rates of PJK have the potential to improve the safety of these operations and decrease cost by eliminating the need for revision surgery.OBJECTIVE: To present a set of surgical techniques that can decrease rates of PJK in adults undergoing surgery for spinal deformity.METHODS: We summarize the use of vertebroplasty, transverse process hooks, terminal rod contouring, and ligament augmentation as means to reduce rates of PJK.RESULTS: We present PJK prevention strategies and a video technique guide that are safe, technically feasible, and add minimal operative time to these surgical procedures. When applied to appropriate high-risk patients, these techniques have the potential to dramatically reduce rates of PJK, which improves quality of life and decreases the cost associated with this treating adult spinal deformity.CONCLUSION: PJK prevention strategies represent a critical area for improvement in surgery for adult spinal deformity. We present a summary of techniques that are safe, feasible, and add minimal time to the overall procedure. These techniques warrant investigation in a thoughtful, prospective manner, but are supported by existing data and compelling biomechanical rationale. Our hope is that these strategies can be applied, particularly in high-risk patients, to help reduce rates of PJK.
KW - Deformity
KW - Ligament augmentation
KW - Prevention strategies
KW - Proximal junctional kyphosis
KW - Spine
KW - Vertebroplasty
UR - http://www.scopus.com/inward/record.url?scp=85030662763&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030662763&partnerID=8YFLogxK
U2 - 10.1093/ons/opx054
DO - 10.1093/ons/opx054
M3 - Article
C2 - 28922883
AN - SCOPUS:85030662763
SN - 2332-4252
VL - 13
SP - 581
EP - 585
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 5
ER -