Incidence of postoperative reciprocal change in thoracic segments and proximal junctional kyphosis in adult spinal deformity patients after corrective long spinal fusion including sacrum and ilium

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  • KATAYANAGI Junya
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center
  • IIDA Takahiro
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center
  • HAYAMIZU Atsuki
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center
  • MATSUMOTO Kazuyuki
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center
  • SUZUKI Moe
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center
  • OZEKI Satoru
    Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center

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Other Title
  • 胸椎前弯を伴う成人脊柱変形患者のproximal junctional kyphosisの発生頻度とその病的意義に関する報告
  • キョウツイ ゼンワン オ トモナウ セイジン セキチュウ ヘンケイ カンジャ ノ proximal junctional kyphosis ノ ハッセイ ヒンド ト ソノ ビョウテキ イギ ニ カンスル ホウコク

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<p>In adult spinal deformity (ASD) patients with a compensatory decrease in thoracic kyphosis (TK), both TK and the PJA (proximal junctional angle) increase postoperatively following surgery for restoration of lumbar lordosis. According to existing definitions this postoperative PJA progression is classified as PJK (proximal junctional kyphosis), but in ASD how does the magnitude of this progression correlate to the incidence of proximal junctional failure (PJF)? We retrospectively reviewed pre- and post-operative radiographs of 40 patients with ASD (mean age, 68.5 years) who underwent corrective spinal surgery (from T10 to sacrum and ilium) in our institution for lumbar kyphotic deformity. From these we compared two sub-groups where the P (positive) group (16 cases) had a preoperative PJA≥5°, and the N (negative) group (8 cases) had a preoperative PJA≤-5°. The preop to final follow-up PJA change was significantly greater in the N group than in the P group, but no other differences were found in other sagittal plane radiographic parameters, or HRQOL, or the incidence of PJK and PJF. In spinal deformity patients with compensatory thoracic lordosis, the preoperative PJA does not correlate to the incidence of junctional failure such as PJK or PJF.</p>

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