Incidence and radiological risk factors of proximal junctional kyphosis in adolescent idiopathic scoliosis following pedicle screw instrumentation with rod derotation and direct vertebral rotation: A minimum 5-year follow-up study

Hong Jin Kim, Jae Hyuk Yang, Dong Gune Chang, Se Il Suk, Seung Woo Suh, Ji Su Kim, Sang Il Kim, Kwang Sup Song, Woojin Cho

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1 Scopus citations

Abstract

Several studies have reported incidence and risk factors for the development of proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS). However, there is little information regarding long-term follow-up after pedicle screw instrumentation (PSI) with rod derotation (RD) and direct vertebral rotation (DVR). Sixty-nine AIS patients who underwent deformity correction using PSI with RD and DVR were retrospectively analyzed in two groups according to the occurrence of PJK, with a minimum five-year follow-up, including a non-PJK group (n = 62) and PJK group (n = 7). Radiological parameters were evaluated at preoperative, postoperative, and last follow-up. Incidence for PJK was 10.1% (7/69 patients), with a mean 9.4-year follow-up period. The thoracolumbar/lumbar curve (TL/L curve) was proportionally higher in the PJK group. The proximal compensatory curve was significantly lower in the PJK group than in the non-PJK group preoperatively (p = 0.027), postoperatively (p = 0.001), and at last follow-up (p = 0.041). The development of PJK was associated with the TL/L curve pattern, lower preoperative proximal compensatory curve, and over-correction of the proximal curve for PSI with RD and DVR. Therefore, careful evaluation of compensatory curves as well as of the main curve is important to prevent the development of PJK in the treatment of AIS.

Original languageEnglish (US)
Article number5351
JournalJournal of Clinical Medicine
Volume10
Issue number22
DOIs
StatePublished - Nov 1 2021

Keywords

  • Adolescent idiopathic scoliosis
  • Direct vertebral rotation
  • Pedicle screw instrumentation
  • Proximal junctional kyphosis
  • Rod derotation

ASJC Scopus subject areas

  • Medicine(all)

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