Patient Optimization for the Prevention of Proximal Junctional Kyphosis

Brendan F Judy; Jovanna A Tracz; Safwan Alomari; Timothy F Witham

doi:10.14444/8510

Patient Optimization for the Prevention of Proximal Junctional Kyphosis

Int J Spine Surg. 2023 Oct;17(S2):S18-S25. doi: 10.14444/8510. Epub 2023 Jun 15.

Authors

Brendan F Judy¹, Jovanna A Tracz², Safwan Alomari², Timothy F Witham²

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA bjudy1@jhmi.edu.
² Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA.

PMID: 37321646
PMCID: PMC10626129
DOI: 10.14444/8510

Abstract

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.

Keywords: proximal junctional failure; proximal junctional kyphosis; pseudarthrosis; spine deformity; spine fusion.

This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.