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

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...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	adolescent idiopathic scoliosis pedicle screw instrumentation rod derotation direct vertebral rotation proximal junctional kyphosis Medicine R
Acceso en línea:	https://doaj.org/article/61e6fe06c5b54842809254d4f12ff94b
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spelling	oai:doaj.org-article:61e6fe06c5b54842809254d4f12ff94b2021-11-25T18:01:59ZIncidence 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 Study10.3390/jcm102253512077-0383https://doaj.org/article/61e6fe06c5b54842809254d4f12ff94b2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5351https://doaj.org/toc/2077-0383Several 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 (<i>n</i> = 62) and PJK group (<i>n</i> = 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 (<i>p</i> = 0.027), postoperatively (<i>p</i> = 0.001), and at last follow-up (<i>p</i> = 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.Hong Jin KimJae Hyuk YangDong-Gune ChangSe-Il SukSeung Woo SuhJi Su KimSang-Il KimKwang-Sup SongWoojin ChoMDPI AGarticleadolescent idiopathic scoliosispedicle screw instrumentationrod derotationdirect vertebral rotationproximal junctional kyphosisMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5351, p 5351 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adolescent idiopathic scoliosis pedicle screw instrumentation rod derotation direct vertebral rotation proximal junctional kyphosis Medicine R
spellingShingle	adolescent idiopathic scoliosis pedicle screw instrumentation rod derotation direct vertebral rotation proximal junctional kyphosis Medicine R 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 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
description	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 (<i>n</i> = 62) and PJK group (<i>n</i> = 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 (<i>p</i> = 0.027), postoperatively (<i>p</i> = 0.001), and at last follow-up (<i>p</i> = 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.
format	article
author	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
author_facet	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
author_sort	Hong Jin Kim
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/61e6fe06c5b54842809254d4f12ff94b
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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

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