RT Journal Article SR Electronic T1 Patient Optimization for the Prevention of Proximal Junctional Kyphosis JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP S18 OP S25 DO 10.14444/8510 VO 17 IS S2 A1 Brendan F. Judy A1 Jovanna A. Tracz A1 Safwan Alomari A1 Timothy F. Witham YR 2023 UL https://www.ijssurgery.com/content/17/S2/S18.abstract AB Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-recognized challenges of surgery for adult spinal deformity (ASD). Multiple risk factors have been identified for PJK/PJF, including osteoporosis, frailty, neurodegenerative disease, obesity, and smoking. Several surgical techniques to mitigate risk of PJK/PJF have been identified; however, patient optimization is also critical. This review summarizes the data behind these 5 risk factors (osteoporosis, frailty, neurodegenerative disease, obesity, and smoking) and details the related recommendations for patients undergoing surgery for ASD.