TY - JOUR
T1 - Results of the 2014 SRS survey on PJK/PJF
T2 - A report on variation of select SRS member practice patterns, treatment indications, and opinions on classification development
AU - SRS Adult Spinal Deformity Committee
AU - Scheer, Justin K.
AU - Fakurnejad, Shayan
AU - Lau, Darryl
AU - Daubs, Michael D.
AU - Coe, Jeffrey D.
AU - Paonessa, Kenneth J.
AU - LaGrone, Michael O.
AU - Amaral, Rodrigo A.
AU - Trobisch, Per D.
AU - Lee, Jung Hee
AU - Fabris-Monterumici, Daniel
AU - Anand, Neel
AU - Cree, Andrew K.
AU - Hart, Robert A.
AU - Hey, Lloyd A.
AU - Ames, Christopher P.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc.
PY - 2015
Y1 - 2015
N2 - Study Design. An electronic survey administered to Scoliosis Research Society membership. Objective. To characterize surgeon views regarding proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) management providing the framework in which a PJK/PJF classification system and treatment guidelines could be established. Summary of Background Data. PJK/PJF are common complications of adult spinal deformity surgery. To date, there is no consensus on PJK/PJF definitions, classification, and indications for revision surgery. There is a paucity of data on deformity surgeon practice pattern variations and consensus opinion on treatment and prevention. Methods. An electronic 19-question survey regarding PJK/PJF was administered to members of the Scoliosis Research Society who treat adult spinal deformity. Determinants included the surgeons' type of practice, number of years in practice, agreement with given PJK/PJF definitions, importance of key factors influencing prevention and revision, prevention methods currently used, and the importance of developing a classification system. Results. A total of 226 surgeons responded (38.8% response rate). Both 44.4% of surgeons selected "extremely important" and 40.8% selected "very important" that PJK in adult spinal deformity surgery is a very important issue and that a Scoliosis Research Society PJK/PJF classification system and guidelines for detection and prevention of PJK/PJF is a "must have" (18.1%) and "very likely helpful" (31.9%). Both 86.2% and 90.7% of surgeons agreed with the provided definitions of PJK and PJF, respectively. Top 5 revision indications included neurological deficit, severe focal pain, translation or subluxation fracture, a change in kyphosis angle of greater than 30°, chance fracture, spondylolisthesis greater than 6 mm, and instrumentation prominence. The majority of respondents use a PJK/PJF prevention strategy 60% of the time or more, the most common were terminal rod contour, preoperative bone mineral density testing, and frequent radiographical studies during first 3 months postoperative, preoperative bone mineral density medication for low bone mineral density. Conclusion. The results of this study provide insight from the practicing surgeons' perspective of the management of PJK and PJF that may aid in the validation of current definitions and consensusbased treatment decisions and prevention guidelines.
AB - Study Design. An electronic survey administered to Scoliosis Research Society membership. Objective. To characterize surgeon views regarding proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) management providing the framework in which a PJK/PJF classification system and treatment guidelines could be established. Summary of Background Data. PJK/PJF are common complications of adult spinal deformity surgery. To date, there is no consensus on PJK/PJF definitions, classification, and indications for revision surgery. There is a paucity of data on deformity surgeon practice pattern variations and consensus opinion on treatment and prevention. Methods. An electronic 19-question survey regarding PJK/PJF was administered to members of the Scoliosis Research Society who treat adult spinal deformity. Determinants included the surgeons' type of practice, number of years in practice, agreement with given PJK/PJF definitions, importance of key factors influencing prevention and revision, prevention methods currently used, and the importance of developing a classification system. Results. A total of 226 surgeons responded (38.8% response rate). Both 44.4% of surgeons selected "extremely important" and 40.8% selected "very important" that PJK in adult spinal deformity surgery is a very important issue and that a Scoliosis Research Society PJK/PJF classification system and guidelines for detection and prevention of PJK/PJF is a "must have" (18.1%) and "very likely helpful" (31.9%). Both 86.2% and 90.7% of surgeons agreed with the provided definitions of PJK and PJF, respectively. Top 5 revision indications included neurological deficit, severe focal pain, translation or subluxation fracture, a change in kyphosis angle of greater than 30°, chance fracture, spondylolisthesis greater than 6 mm, and instrumentation prominence. The majority of respondents use a PJK/PJF prevention strategy 60% of the time or more, the most common were terminal rod contour, preoperative bone mineral density testing, and frequent radiographical studies during first 3 months postoperative, preoperative bone mineral density medication for low bone mineral density. Conclusion. The results of this study provide insight from the practicing surgeons' perspective of the management of PJK and PJF that may aid in the validation of current definitions and consensusbased treatment decisions and prevention guidelines.
KW - Adult spinal deformity
KW - Classification system
KW - PJF
KW - PJK
KW - PJK prevention strategies
KW - Proximal junctional failure
KW - Proximal junctional kyphosis
KW - Scoliosis
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UR - http://www.scopus.com/inward/citedby.url?scp=84941918837&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000000897
DO - 10.1097/BRS.0000000000000897
M3 - Review article
C2 - 25811261
AN - SCOPUS:84941918837
SN - 0362-2436
VL - 40
SP - 829
EP - 840
JO - Spine
JF - Spine
IS - 11
ER -