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Review
. 2022 Jun 28;7(2):120-128.
doi: 10.22603/ssrr.2022-0100. eCollection 2023 Mar 27.

Proximal Junctional Kyphosis in Modern Spine Surgery: Why Is it So Common?

Jean Dubousset  1 , Bassel G Diebo  2   3
Affiliations
Review

Proximal Junctional Kyphosis in Modern Spine Surgery: Why Is it So Common?

Jean Dubousset et al. Spine Surg Relat Res. .

Abstract

In the past few decades, proximal junctional kyphosis (PJK) has emerged as a new complication after instrumented spinal fusion in adult and pediatric spinal deformities. This phenomenon has occurred concomitantly with the rise of robust instrumentation techniques and enhancement of our abilities to obtain greater spinal deformity correction. The goal of this paper is to review the mechanical and biological causes of PJK and recommend prevention strategies.

Keywords: Cone of Economy; Pelvic vertebra; Proximal junctional kyphosis; Sagittal alignment; Spinal deformity.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
Example of PJK in pediatric (left) and adult (right) patients.
Figure 2.
Figure 2.
Schematic representation of the chain of alignment. Reproduction from “Cone of Economy with the Chain of Balance -Historical Perspective and Proof of Concept” (https://doi.org/10.22603/ssrr.2022-0038).
Figure 3.
Figure 3.
Cone of Economy concept as described by Dr. Dubousset in 1975. Reproduction from “Cone of Economy with the Chain of Balance -Historical Perspective and Proof of Concept” (https://doi.org/10.22603/ssrr.2022-0038).
Figure 4.
Figure 4.
The four components of the Dubousset Functional Test.
Figure 5.
Figure 5.
Case example of multiple recurrent PJK. Preoperative image (A), followed by radiographs after the index procedure (B). The patient developed PJK (C), subsequently underwent revision (D), and developed recurrent PJK (E). Reprinted with permission from Kim et al..
See this image and copyright information in PMC

References

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