Abstract:Objective To summarize and conclude recent development of Proximal junctional kyphosis (PJK).Methods To search the references related to PJK using "proximal junctional kyphosis", "incidence", "spine" and “近端交界性后凸”,“发生率”,“脊柱” as the key words in the PubMed and Wanfang database from January 2000 to May 2015. To summarize in aspect of biomechanical influence factors, the radiographic parameters, the diagnosis, type, the clinical factors of PJK.Results By analyzing and concluding, using cross-linkage at proximal area can decrease the incidence of PJK, however, older age at surgery>50 years, lumbar lordosis angle>30°, preoperatively thoracic scoliosis angle>30°, thoracic kyphosis>30°, change of lumbar lordosis angle between preoperatively and postoperatively>30°, thoracic kyphosis angle of T5-T12 thoracic kyphosis>40°, combination of anterior and posterior surgery were probably risk factors of PJK. There was no consensus on the point of view of PJK diagnosis and surgical indication for revision of PJK.Conclusions PJK occurs as a result of interaction of multiple factors. It is certainly associated with the biomechanics of the spine, radiographic parameters, and clinical factors. But the risk factors of PJK are still unclear, and need to be explored by further study.
王涛,王辉,魏海醌,刘丰雨,丁文元. 脊柱术后近端交界性后凸畸形的研究进展[J]. 中华解剖与临床杂志, 2016, 21(5): 485-488.
Wang Tao, Wang Hui, Wei Haikun, Liu Fengyu, Ding Wenyuan.. The recent development of proximal junctional kyphosis after spinal surgery. Chinese Journal of Anatomy and Clinics, 2016, 21(5): 485-488.
Kim HJ, Lenke LG, Shaffrey CI, et al. Proximal junctional kyphosis as a distinct form of adjacent segment pathology after spinal deformity surgery: a systematic review[J]. Spine(Phila Pa 1976), 2012, 37(22 Suppl): S144-S164. DOI:10.1097/BRS.0b013e31826d611b
Kim YJ, Bridwell KH, Lenke LG, et al. Proximal junctional kyphosis in adult spinal deformity after segmental posterior spinal instrumentation and fusion: minimum five-year follow-up[J]. Spine(Phila Pa 1976), 2008, 33(20): 2179-2184. DOI:10.1097/BRS.0b013e31817c0428
[4]
Cammarata M, Aubin C, Wang X, et al. Biomechanical risk factors for proximal junctional kyphosis: a detailed numerical analysis of surgical instrumentation variables[J]. Spine(Phila Pa 1976), 2014, 39(8): E500-E507. DOI:10.1097/BRS.0000000000000222
[5]
Maruo K, Ha Y, Inoue S, et al. Predictive factors for proximal junctional kyphosis in long fusions to the sacrum in adult spinal deformity[J]. Spine(Phila Pa 1976), 2013, 38(23): E1469-E1476. DOI:10.1097/BRS.0b013e3182a51d43
[6]
Wang J, Zhao Y, Shen B, et al. Risk factor analysis of proximal junctional kyphosis after posterior fusion in patients with idiopathic scoliosis[J]. Injury, 2010, 41(4):415-420. DOI:10.1016/j.injury.2010.01.001
[7]
Kim YJ, Lenke LG, Bridwell KH, et al . Proximal junctional kyphosis in adolescent idiopathic scoliosis after 3 different types of posterior segmental spinal instrumentation and fusions: incidence and risk factor analysis of 410 cases[J]. Spine (Phila Pa 1976), 2007, 32(24): 2731-2738. DOI: 10.1097/BRS.0b013e31815a7ead
[8]
Lee GA, Betz RR, Clements DH 3rd, et al. Proximal kyphosis after posterior spinal fusion in patients with idiopathic scoliosis[J]. Spine(Phila Pa 1976), 1999, 24(8): 795-799.
[9]
Yagi M, King AB, Boachie-Adjei O. Incidence, risk factors, and natural course of proximal junctional kyphosis: surgical outcomes review of adult idiopathic scoliosis. Minimum 5 years of follow-up[J]. Spine(Phila Pa 1976), 2012, 37(17): 1479-1489. DOI:10.1097/BRS.0b013e31824e4888
[10]
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]. J Neurosurg Spine, 2013, 19(3): 360-369. DOI:10.3171/2013.5.SPINE12737
[11]
Sacramento-Domínguez C, Vayas-Díez R, Coll-Mesa L, et al. Reproducibility measuring the angle of proximal junctional kyphosis using the first or the second vertebra above the upper instrumented vertebrae in patients surgically treated for scoliosis[J]. Spine(Phila Pa 1976), 2009, 34(25): 2787-2791. DOI:10.1097/BRS.0b013e3181b61955
[12]
Helgeson MD, Shah SA, Newton PO, et al. Evaluation of proximal junctional kyphosis in adolescent idiopathic scoliosis following pedicle screw, hook, or hybrid instrumentation[J]. Spine(Phila Pa 1976), 2010, 35(2): 177-181. DOI:10.1097/BRS.0b013e3181c77f8c
[13]
Kim YJ, Bridwell KH, Lenke LG, et al . Proximal junctional kyphosis in adolescent idiopathic scoliosis following segmental posterior spinal instrumentation and fusion: minimum 5-year follow-up[J]. Spine(Phila Pa 1976), 2005, 30(18): 2045-2050
[14]
Bridwell KH, Lenke LG, Cho SK, et al. Proximal junctional kyphosis in primary adult deformity surgery: evaluation of 20 degrees as a critical angle[J]. Neurosurgery, 2013, 72(6): 899-906. DOI:10.1227/NEU.0b013e31828bacd8
[15]
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[J]. Spine (Phila Pa 1976), 2015, 40(11): 829-840.DOI: 10.1097/BRS.0000000000000897
[16]
Yagi M, Akilah KB, Boachie-Adjei O. Incidence, risk factors and classification of proximal junctional kyphosis: surgical outcomes review of adult idiopathic scoliosis[J]. Spine(Phila Pa 1976), 2011, 36(1): E60-E68. DOI:10.1097/BRS.0b013e3181eeaee2
[17]
Hollenbeck SM, Glattes RC, Asher MA, et al. The prevalence of increased proximal junctional flexion following posterior instrumentation and arthrodesis for adolescent idiopathic scoliosis[J]. Spine(Phila Pa 1976), 2008, 33(15): 1675-1681. DOI:10.1097/BRS.0b013e31817b5bea
[18]
Kim HJ, Yagi M, Nyugen J, et al. Combined anterior-posterior surgery is the most important risk factor for developing proximal junctional kyphosis in idiopathic scoliosis[J]. Clin Orthop Relat Res, 2012, 470(6): 1633-1639. DOI:10.1007/s11999-011-2179-1
[19]
Yang SH, Chen PQ. Proximal kyphosis after short posterior fusion for thoracolumbar scoliosis[J]. Clin Orthop Relat Res, 2003(411): 152-158. DOI:10.1097/01.blo.0000069885.72909.bb
[20]
Wang Y, Kawakami N, Tsuji T, et al. Proximal junctional kyphosis following posterior hemivertebra resection and short fusion in children younger than 10 years[J]. J Spinal Disord Tech, 2015. [Epub ahead of print]. DOI:10.1097/BSD.0000000000000245
[21]
O′Shaughnessy BA, Bridwell KH, Lenke LG, et al. Does a long-fusion "T3-sacrum" portend a worse outcome than a short-fusion "T10-sacrum" in primary surgery for adult scoliosis[J]. Spine(Phila Pa 1976), 2012, 37(10): 884-890. DOI:10.1097/BRS.0b013e3182376414
[22]
Watanabe K, Uno K, Suzuki T, et al. Risk factors for proximal junctional kyphosis associated with dual-rod growing-rod surgery for early-onset scoliosis[J]. J Spinal Disord Tech, 2014. [Epub ahead of print]. DOI:10.1097/BSD.0000000000000127.
[23]
Lee JH, Kim JU, Jang JS, et al. Analysis of the incidence and risk factors for the progression of proximal junctional kyphosis following surgical treatment for lumbar degenerative kyphosis: minimum 2-year follow-up[J]. Br J Neurosurg, 2014, 28(2): 252-258. DOI:10.3109/02688697.2013.835369
[24]
Cecchinato R, Berjano P, Bassani R, et al. Osteotomies in proximal junctional kyphosis in the cervicothoracic area[J]. Eur Spine J, 2015, 24(Suppl 1): S31-S37. DOI:10.1007/s00586-014-3654-7
[25]
Kim HJ, Bridwell KH, Lenke LG, et al. Patients with proximal junctional kyphosis requiring revision surgery have higher postoperative lumbar lordosis and larger sagittal balance corrections[J]. Spine(Phila Pa 1976), 2014, 39(9): E576-E580. DOI:10.1097/BRS.0000000000000246
[26]
Inoue S, Khashan M, Fujimori T, et al. Analysis of mechanical failure associated with reoperation in spinal fusion to the sacrum in adult spinal deformity[J]. J Orthop Sci, 2015, 20(4): 609-616. DOI:10.1007/s00776-015-0729-1
[27]
Reames DL, Kasliwal MK, Smith JS, et al. Time to development, clinical and radiographic characteristics, and management of proximal junctional kyphosis following adult thoracolumbar instrumented fusion for spinal deformity[J]. J Spinal Disord Tech, 2015, 28(2): E106-E114. DOI:10.1097/BSD.0000000000000158.
[28]
Hart R, McCarthy I, O′brien M, et al. Identification of decision criteria for revision surgery among patients with proximal junctional failure after surgical treatment of spinal deformity[J]. Spine(Phila Pa 1976), 2013, 38(19): E1223-E1227. DOI:10.1097/BRS.0b013e31829fedde.
[29]
Smith MW, Annis P, Lawrence BD, et al . Acute proximal junctional failure in patients with pre-operative sagittal imbalance[J]. Spine J, 2015, 15(10): 2142-2148. DOI: 10.1016/j.spinee.2015.05.028