Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment

Technical advancements have enabled the spinal deformity surgeon to correct severe spinal mal-alignment. However, proximal adjacent segment pathology (ASP) remains a significant issue. Examples include proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Agreement on the definit...

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Bibliographic Details
Published in:Current reviews in musculoskeletal medicine 2016-09, Vol.9 (3), p.299-308
Main Authors: Nguyen, Ngoc-Lam M., Kong, Christopher Y., Hart, Robert A.
Format: Article
Language:English
Subjects:
Complications in Spine Surgery (E Klineberg
Complications in Spine Surgery (E Klineberg, Section Editor)
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Orthopedics
Rehabilitation Medicine
Section Editor
Sports Medicine
Surgery
Surgical Orthopedics
Topical Collection on Complications in Spine Surgery
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Summary:Technical advancements have enabled the spinal deformity surgeon to correct severe spinal mal-alignment. However, proximal adjacent segment pathology (ASP) remains a significant issue. Examples include proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Agreement on the definition, classification, and pathophysiology of PJK and PJF remains incomplete, and an understanding of the risk factors, means of prevention, and treatment of this problem remains to be elucidated. In general, PJK is a relatively asymptomatic radiographic diagnosis managed with patient reassurance and monitoring. On the other hand, PJF is characterized by mechanical instability, pain, and more severe kyphosis, with potential for neurologic compromise. Patients who develop PJF more often require revision surgery than those with PJK. This chapter will review the current understanding of PJK and PJF.
ISSN:1935-973X
1935-9748
DOI:10.1007/s12178-016-9353-8