RT Journal Article
SR Electronic
T1 Revision Surgery for Proximal Junctional Kyphosis and the Role for Addressing Residual Deformity
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8512
DO 10.14444/8512
A1 Clohisy, John C.F.
A1 Kim, Han Jo
YR 2023
UL https://www.ijssurgery.com/content/early/2023/06/22/8512.abstract
AB Proximal junctional kyphosis (PJK) is a common complication of adult spinal deformity surgery. Initially described in Scheuermann kyphosis and adolescent scoliosis, PJK now represents a wide spectrum of diagnoses and severities. Proximal junctional failure (PJF) is the most severe form of PJK. Revision surgery for PJK may improve outcomes in the setting of intractable pain, neurological deficits, and/or progressive deformity. Accurate diagnosis of the driver(s) of PJK and a surgical strategy that addresses these factors are required to optimize outcomes for revision surgery and to avoid recurrent PJK. One such factor is residual deformity. Recent investigations on recurrent PJK have identified radiographic parameters that may be useful in revision surgery to minimize the risk of recurrent PJK. In this review, we discuss classification systems used to guide sagittal plane correction and literature investigating their utility in predicting and preventing PJK/PJF, we review the literature on revision surgery for PJK and addressing residual deformity, and we present illustrative cases.