Proximal junctional vertebral fracture-subluxation after adult spine deformity surgery. Does vertebral augmentation avoid this complication? A case report.
Nicomedes Fernández-Baíllo,José Miguel Sánchez Márquez,Francisco Javier Sánchez Pérez-Grueso,Alfredo García Fernández +3 more
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TLDR
Augmentation of the cranial level in a long thoracolumbar fusion has been developed to avoid the junctional kyphosis and compression fractures at that level, although this opinion requires investigation for confirmation.Abstract:
Background
To report to the orthopedic community a case of vertebral fracture and adjacent vertebral subluxation through the upper instrumented vertebra after thoracolumbar fusion with augmentation of the cranial level.read more
Citations
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Proximal junctional kyphosis and failure after spinal deformity surgery: a systematic review of the literature as a background to classification development.
Darryl Lau,Aaron J. Clark,Justin K. Scheer,Daubs,Jeffrey D. Coe,Paonessa Kj,Michael O. Lagrone,Kasten,Amaral Ra,Trobisch Pd,Lee Jh,Fabris-Monterumici D,Neel Anand,Cree Ak,Robert A. Hart,Lloyd A. Hey,Christopher P. Ames +16 more
TL;DR: A PJK and PJF scoring system may help describe the severity of disease and guide the need for revision surgery and the development and prospective validation of a PJK classification system is important considering the prevalence of the problem and its clinical and economic impact.
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Use of vertebroplasty to prevent proximal junctional fractures in adult deformity surgery: A biomechanical cadaveric study
Khaled M. Kebaish,Christopher T. Martin,Joseph R. O'Brien,Ivan E. LaMotta,Gabor Voros,Stephen M. Belkoff +5 more
TL;DR: Prophylactic vertebroplasty at the upper instrumented level and its supra-adjacent vertebra reduced the incidence of junctional fractures after long posterior spinal instrumentation in this axially loaded cadaveric model.
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Junctional spinal disorders in operated adult spinal deformities: present understanding and future perspectives
Vincent Arlet,Max Aebi +1 more
TL;DR: Definitively the issue of junctional spinal disorder after deformity surgery will require further extensive research to minimize this problem especially in the authors' aging population.
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Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment
TL;DR: This chapter will review the current understanding of PJK and PJF, which is characterized by mechanical instability, pain, and more severe kyphosis, with potential for neurologic compromise.
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Proximal Junctional Kyphosis: Diagnosis, Pathogenesis, and Treatment.
Jaewon Lee,Ye Soo Park +1 more
TL;DR: The clinical significance and impact of proximal junctional kyphosis is determined by reviewing relevant papers that have been published to date and finding a strategic approach to the proper treatment of PJK.
References
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Risk factors for adjacent-segment failure following lumbar fixation with rigid instrumentation for degenerative instability.
Shahin Etebar,David W. Cahill +1 more
TL;DR: The risk of adjacent-segment failure is clearly higher for patients in whom lumbar fusion with rigid instrumentation is performed to treat degenerative instability, and this risk appears to be especially high in postmenopausal women.
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Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65 : Surgical considerations and treatment options in patients with poor bone quality
TL;DR: Spinal stabilization surgery in patients with poor bone stock is associated with high complication rates and complications such as progressive kyphosis adjacent to the fusion are difficult to address with instrumentation alone.
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Adult scoliosis: surgical indications, operative management, complications, and outcomes.
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Percutaneous treatment of vertebral compression fractures: a meta-analysis of complications.
TL;DR: It appears that VP is associated with a statistically significant increased rate of procedure-related complications and cement extravasation (symptomatic and asymptomatic).
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Proximal junctional vertebral fracture in adults after spinal deformity surgery using pedicle screw constructs: analysis of morphological features.
Kei Watanabe,Lawrence G. Lenke,Keith H. Bridwell,Yongjung J. Kim,Linda A. Koester,Marsha Hensley +5 more
TL;DR: Old age, osteopenia, preoperative comorbidities, and severe global sagittal imbalance were found to be frequent in patients with proximal junctional fracture and marked correction of sagittal malalignment might be considered as a risk factor of upper instrumented vertebra collapse followed by adjacent vertebral subluxation.