Abstract
Study Design. Retrospective analysis of prospective data. Objective. Evaluate the utility of the Hart-International Spine Study Group proximal junctional kyphosis severity scale (Hart-ISSG PJKSS). Summary of Background Data. Proximal junctional kyphosis (PJK) and failure (PJF) are well-described complications after long-segment instrumentation. The Hart-ISSG PJKSS was recently developed and incorporates neurological deficit, pain, instrumentation issues, degree of kyphosis, presence of fracture, and level of upper-most instrumented vertebrae. Methods. All adult spinal deformity patients with PJK or PJF were identified from two academic centers over a 7-year period. Health-related quality-of-life (HRQOL) outcomes were prospectively collected: Oswestry Disability Index (ODI), visual analogue scale (VAS) pain, SF-36 questionnaire, and SRS-30 questionnaire. Patients were retrospectively assigned Hart-ISSG PJKSS scores. Correlation between the Hart-ISSG PJKSS and outcomes was assessed with linear regression, Pearson correlation coefficients, and χ 2 analysis. Results. A total of 184 cases were included; 21.2% were men and mean age was 65.0 years. Weakness and/or myelopathy were present in 11.4% of patients and 88.6% had pain. Instrumentation issues occurred in 44.0% and 64.1% had PJK-associated fractures. PJK occurred in the upper thoracic spine in 21.7% of cases. Mean PJKSS score was 5.9. The Hart-ISSG PJKSS was significantly and strongly associated with ODI (P
Original language | English (US) |
---|---|
Pages (from-to) | 213-223 |
Number of pages | 11 |
Journal | Spine |
Volume | 41 |
Issue number | 3 |
DOIs | |
State | Published - Feb 1 2016 |
Keywords
- classification
- instrumentation
- proximal junctional failure
- proximal junctional kyphosis
- quality of life
- revision surgery
- severity scale
ASJC Scopus subject areas
- Clinical Neurology
- Orthopedics and Sports Medicine