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State of the art: proximal junctional kyphosis—diagnosis, management and prevention

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A Letter to the Editor to this article was published on 25 September 2021

Abstract

Proximal junctional kyphosis (PJK) is a common problem that may occur following the surgical treatment of adult patients with spinal deformity. It is defined as the proximal junctional sagittal angle from the UIV and UVI + 2 of at least 10° AND at least 10° greater than the preop measurement. The reported incidence of radiographic PJK in the literature varies between 17 and 46%. A smaller subset of these patients may need revision surgery and are defined as proximal junctional failure (PJF), which can be associated with vertebral fracture, vertebral subluxation, failure of instrumentation, and neurological deficits. Several risk factors for development of PJK have been proposed. However, large-scale prospective studies are needed to better identify strategies to reduce the incidence of PJK.

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Funding

This study was not funded by a grant.

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Authors and Affiliations

  1. Spine and Scoliosis Surgery, College of Physicians and Surgeons, NewYork-Presbyterian, The Allen Hospital, Columbia University, 5141 Broadway, New York, NY, 3FW, USA

    Zeeshan M. Sardar, Yongjung Kim & Lawrence Lenke

  2. Hospital for Special Surgery, New York, NY, USA

    Virginie Lafage

  3. New England Baptist Hospital, Boston, MA, USA

    Frank Rand

  4. University of California - Davis, Sacramento, CA, USA

    Eric Klineberg

Authors
  1. Zeeshan M. Sardar
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  2. Yongjung Kim
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  4. Frank Rand
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  5. Lawrence Lenke
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  6. Eric Klineberg
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SRS Adult Spinal Deformity Committee

Contributions

ZMS, YK, VL, FR, LL, EK: Contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work, Drafting the work or revising it critically for important intellectual content, Final approval of the version to be published and Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Zeeshan M. Sardar.

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Conflict of interest

Dr. Sardar reports personal fees from Medtronic Inc, personal fees from Stryker Spine, outside the submitted work. Dr. Kim has nothing to disclose. Dr. Lenke reports personal fees from Medtronic, grants and personal fees from DePuy-Synthes Spine, personal fees from K2M, non-financial support from Broadwater, non-financial support from Seattle Science Foundation, grants and non-financial support from Scoliosis Research Society, non-financial support from Stryker Spine, non-financial support from The Spinal Research Foundation, grants from EOS, grants from Setting Scoliosis Straight Foundation, personal fees from Fox Rothschild, LLC, personal fees from Quality Medical Publishing, other from Evans Family Donation, other from Fox Family Foundation, grants and non-financial support from AOSpine, outside the submitted work. Dr. Lenke reports personal fees from Medtronic, grants and personal fees from DePuy-Synthes Spine, personal fees from K2M, non-financial support from Broadwater, non-financial support from Seattle Science Foundation, grants and non-financial support from Scoliosis Research Society, non-financial support from Stryker Spine, non-financial support from The Spinal Research Foundation, grants from EOS, grants from Setting Scoliosis Straight Foundation, personal fees from Fox Rothschild, LLC, personal fees from Quality Medical Publishing, other from Evans Family Donation, other from Fox Family Foundation, grants and non-financial support from AOSpine, outside the submitted work. Dr. Lafage reports personal fees from Globus Medical, personal fees from Nuvasive, personal fees from Depuy Synthes Spine, personal fees from The Permanente Medical Group, personal fees from Implanet, outside the submitted work Dr. Rand has nothing to disclose. Dr. Klineberg reports personal fees from Depuy Synthes, personal fees from Stryker, personal fees from Medicrea, grants and personal fees from AOSpine, outside the submitted work.

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Sardar, Z.M., Kim, Y., Lafage, V. et al. State of the art: proximal junctional kyphosis—diagnosis, management and prevention. Spine Deform 9, 635–644 (2021). https://doi.org/10.1007/s43390-020-00278-z

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