Journals / Acta Orthopaedica et Traumatologica Turcica / 2022 / Cilt: 56 - Sayı: 3

Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: A systematic review and meta-analysis

Pages
158–165
Publication Date
2022-10-10
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study aimed to conduct a systematic review and meta-analysis to assess the risk factors for proximal junctional kyphosis after the correction surgery of adult spinal deformity.
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Key Findings & Data:Analysis was performed with Revman 5.3 software.
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Conclusion & Impact:Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: This study aimed to conduct a systematic review and meta-analysis to assess the risk factors for proximal junctional kyphosis after the correction surgery of adult spinal deformity. Methods: Relevant studies were systematically retrieved from databases including Cochrane Library, PubMed, and Embase. Based on inclusion and exclusion criteria, literature screening, quality evaluation, and data extraction were conducted. Analysis was performed with Revman 5.3 software. Results: Sixteen studies with 2388 patients, covering 905 cases with proximal junctional kyphosis and 1483 cases without proximal junctional kyphosis, were included in the study. The high-risk factors for the development of proximal junctional kyphosis were found to be high body mass index, osteoporosis, severe fatty infiltration of paravertebral muscles, small functional area of paravertebral muscles, lumbar lordosis over-correction, lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment, and pelvic fixation. The results were statistically significant. Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment.

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Cite This Article

HAN, X., REN, J. (2022). Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: A systematic review and meta-analysis. Acta Orthopaedica et Traumatologica Turcica, Cilt: 56 - Sayı: 3, 158–165. https://ajindex.com/articles/427966

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References (11)

  1. Grabel ZJ, Hart RA, Clark AJ, et al. Adult spinal deformity knowledge in orthopedic spine surgeons: impact of fellowship training, experience, and practice characteristics. Spine Deform. 2018
  2. 6(1):60-66. [CrossRef] 2. Scheer JK, Fakurnejad S, Lau D, et al. Results of the 2014 SRS survey on PJK/ PJF: A report on variation of select SRS member practice patterns, treatment indications, and opinions on classification development. Spine (Phila Pa 1976). 2015
  3. 40(11):829-840. [CrossRef] 3. Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards C 2nd. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 2005
  4. 30(14):1643-1649. [CrossRef] 4. Raman T, Miller E, Martin CT, Kebaish KM. The effect of prophylactic vertebroplasty on the incidence of proximal junctional kyphosis and proximal junctional failure following posterior spinal fusion in adult spinal deformity: a 5-year follow-up study. Spine J. 2017
  5. 17(10):1489-1498. [CrossRef] 5. Ha Y, Maruo K, Racine L, et al. Proximal junctional kyphosis and clinical outcomes in adult spinal deformity surgery with fusion from the thoracic spine to the sacrum: a comparison of proximal and distal upper instrumented vertebrae. J Neurosurg Spine. 2013
  6. 19(3):360-369. [CrossRef] 6. Liu FY, Wang T, Yang SD, Wang H, Yang DL, Ding WY. Incidence and risk factors for proximal junctional kyphosis: a meta-analysis. Eur Spine J. 2016
  7. 25(8):2376-2383. [CrossRef] 7. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. J Clin Epidemiol. 2009
  8. 62(10):1006-1012. [CrossRef] 8. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010
  9. 25(9):603-605. [CrossRef] 9. Buell TJ, Buchholz AL, Quinn JC, et al. A pilot study on posterior polyethylene tethers to prevent proximal junctional kyphosis After multilevel spinal instrumentation for adult spinal deformity. Oper Neurosurg (Hagerstown). 2019
  10. 16(2):256-266. [CrossRef] 10. Buell TJ, Chen CJ, Quinn JC, et al. Alignment risk factors for proximal junctional kyphosis and the effect of lower thoracic junctional tethers for adult spinal deformity. World Neurosurg. 2019
  11. e96-e103. [CrossRef] 11. Daniels AH, Reid DBC, Durand WM, et al. Upper-thoracic versus lower-thoracic upper instru