RISK FACTORS FOR PROXIMAL JUNCTIONAL KYPHOSIS IN IDIOPATHIC SCOLIOSIS SURGERY
https://doi.org/10.14531/ss2015.3.28-32
Abstract
Objective. To identify risk factors for development of proximal junctional kyphosis (PJK) in patients with idiopathic scoliosis treated with segmental posterior spinal instrumentation.
Material and Methods. Radiographs of 95 patients with idiopathic scoliosis operated on using segmental posterior spinal instrumentation were analyzed. Preoperative and postoperative spondylograms and images taken at the end of the second year of follow-up were evaluated. The PJK was defined as 10° or more increase in the angle of kyphosis between the caudal endplate of the upper instrumented vertebra and the cephalad endplate of two adjacent proximal vertebrae as compared with preoperative angle at the same level.
Results. The prevalence of PJK at the end of the second year of follow-up was 24 %. Before surgery the average value of the proximal transition angle was 6.7° ± 5.4° in patients with PJK (Group I) and 6.1° ± 4.6° in patients who have not formed PJK (Group II). Within two weeks after surgery, the angle increased to 15.0° ± 6.7° in patients of Group I and to 6.9° ± 4.4° in patients of Group II. Two years after surgery the angle was 23.0° ± 6.0° and 8.4° ± 5.6°, respectively.
Conclusion. Statistically significant risk factors were initial hyperkyphosis of the thoracic spine (>40°), significant change in thoracic kyphosis in the postoperative period, initial value of the proximal transition angle, distal location of the upper instrumented vertebra, and the use of hybrid fixation.
About the Authors
Aleksandr Yuryevich Sergunin
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
Mikhail Vitalyevich Mikhailovsky
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
Artyom Nikolayevich Sorokin
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
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Review
For citations:
Sergunin A.Yu., Mikhailovsky M.V., Sorokin A.N. RISK FACTORS FOR PROXIMAL JUNCTIONAL KYPHOSIS IN IDIOPATHIC SCOLIOSIS SURGERY. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2015;12(3):28-32. https://doi.org/10.14531/ss2015.3.28-32
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