Volume 27, Issue 2
DOI: 10.53555/03276716.2018.1073
The contribution of proximal junctional kyphosis to adult spine deformity surgery complications and risk factors
Abstract
Aims: Adult Spinal Deformity (ASD) in adults has recently increased in popularity because of the increasing regard of the older population; however, issues, such as Proximal Junctional Kyphosis (PJK), persist and interfere with the outcome of the procedures. The purpose of this study was to evaluate demographic characteristics, comorbidities, surgical complications, and PJK-specific failures in ASD surgery patients.
Methods: A total of 80 patients aged 50 – 85 years. Data on demographics, comorbidities, and complications were collected. Complications, especially over PJK, were reported regarding its frequency and percentage, along with the Upper Instrumented Vertebrae (UIV) levels in all affected patients. Statistical analysis was used to evaluate potential associations of demographic factors and rates of complications.
Results: Patients had a mean age of 65.2 years (±10.3) and were primarily female (60%). Hypertension and diabetes mellitus were the most frequently observed comorbidities (52.5% and 35.0%, respectively). Out of the patients, 66.25% had complications following the surgery, including 25% resulting in PJK. PJK was most commonly seen at the UIV level of T4 (30%). PJK-related failures comprised bone failure (50%) and implant/bone interface failure (25%).
Conclusion: Our study reveals a complication rate after ASD surgery that is alarmingly high, especially for PJK, and dependent on demographic characteristics and additional diseases. These results highlight the importance of a careful preoperative assessment and individualized surgical approaches to reduce risk. Future research needs to improve on surgery or develop preventative strategies to improve outcomes in this study.
Keywords
spinal surgery, junctional kyphosis, instrumentation, adult spinal deformity