Proximal junctional kyphosis prevention strategies: A video technique guide

Michael M. Safaee, Joseph A. Osorio, Kushagra Verma, Shay Bess, Christopher I. Shaffrey, Justin S. Smith, Robert Hart, Vedat Deviren, Christopher P. Ames

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

BACKGROUND: Proximal junctional kyphosis (PJK) is a well-recognized complication in patients undergoing posterior instrumented fusion procedures for adult spinal deformity. Strategies that reduce rates of PJK have the potential to improve the safety of these operations and decrease cost by eliminating the need for revision surgery.OBJECTIVE: To present a set of surgical techniques that can decrease rates of PJK in adults undergoing surgery for spinal deformity.METHODS: We summarize the use of vertebroplasty, transverse process hooks, terminal rod contouring, and ligament augmentation as means to reduce rates of PJK.RESULTS: We present PJK prevention strategies and a video technique guide that are safe, technically feasible, and add minimal operative time to these surgical procedures. When applied to appropriate high-risk patients, these techniques have the potential to dramatically reduce rates of PJK, which improves quality of life and decreases the cost associated with this treating adult spinal deformity.CONCLUSION: PJK prevention strategies represent a critical area for improvement in surgery for adult spinal deformity. We present a summary of techniques that are safe, feasible, and add minimal time to the overall procedure. These techniques warrant investigation in a thoughtful, prospective manner, but are supported by existing data and compelling biomechanical rationale. Our hope is that these strategies can be applied, particularly in high-risk patients, to help reduce rates of PJK.

Original languageEnglish (US)
Pages (from-to)581-585
Number of pages5
JournalOperative Neurosurgery
Volume13
Issue number5
DOIs
StatePublished - Oct 1 2017

Keywords

  • Deformity
  • Ligament augmentation
  • Prevention strategies
  • Proximal junctional kyphosis
  • Spine
  • Vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Safaee, M. M., Osorio, J. A., Verma, K., Bess, S., Shaffrey, C. I., Smith, J. S., Hart, R., Deviren, V., & Ames, C. P. (2017). Proximal junctional kyphosis prevention strategies: A video technique guide. Operative Neurosurgery, 13(5), 581-585. https://doi.org/10.1093/ons/opx054