PT  - JOURNAL ARTICLE
AU  - BATTISTA, CHRISTOPHER
AU  - WILD, CHRISTOPHER
AU  - KREUL, SARAH
AU  - ALBERT, MICHAEL
TI  - Prevention of Proximal Junctional Kyphosis & Failure Using Sublaminar Bands in a Hybrid Construct in Pediatric Kyphosis Deformity
AID  - 10.14444/5080
DP  - 2018 Dec 01
TA  - International Journal of Spine Surgery
PG  - 644--649
VI  - 12
IP  - 6
4099  - https://www.ijssurgery.com/content/12/6/644.short
4100  - https://www.ijssurgery.com/content/12/6/644.full
SO  - Int J Spine Surg2018 Dec 01; 12
AB  - Purpose: The purpose of this study was to evaluate short term proximal junctional kyphosis and failure (PJK/PJF) rates and clinical outcomes in patients who underwent posterior spinal fusion (PSF) and deformity correction using sublaminar bands in a hybrid construct. Methods: This is a retrospective review of pediatric spinal deformity cases performed by a single surgeon from January 2008 to December 2012. One hundred thirty-six pediatric deformity patient charts were reviewed for inclusion into the study. All 136 patients reviewed had been operatively managed for a spinal deformity and were younger than 18 years of age. Our study's inclusion criteria comprised patients with a kyphosis greater than 60°, the use of sublaminar polyester bands in a hybrid surgical construct, and a minimum of 2 years of follow-up. Of the 136 spinal deformity cases reviewed, 17 cases met our inclusion criteria. No cases were excluded because of technical difficulty of band placement or for not using a hybrid construct with sublaminar bands (as it was the primary surgeon's principal construct of choice). PJK was defined as proximal junction sagittal Cobb angle (PJA) of at least 10° greater than the preoperative measurement. This was assessed by comparison of preoperative and postoperative radiographs. Our hypothesis was that PSF performed with our technique would have a lower rate of PJK than previously reported with other methods of fixation.Results: The range of the preoperative kyphosis was 62°–111°, and postoperative kyphosis was 12°–55°. There was one case of PJK (5.8%) and no cases of PJF.Conclusion: This study on short term outcomes of PSF using sublaminar bands in a hybrid technique for treatment of kyphosis demonstrated a lower rate of PJK than has been reported in prior studies. This technique protects the fixation within the upper instrumented vertebrae of long segment PSFs.