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Proximal junctional kyphosis and rates of fusion following posterior instrumentation and spinal fusion for adolescent idiopathic scoliosis
Author(s) -
Sinagra Zachary,
Cunningham Gregory,
Dillon David,
Woodland Peter,
Baddour Edward
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15706
Subject(s) - medicine , kyphosis , vertebra , radiography , spinal fusion , scoliosis , surgery , bone grafting , idiopathic scoliosis
Background Proximal junctional kyphosis (PJK) can cause significant functional impairment and neural compression. Varying rates of PJK and pseudoarthrosis following posterior instrumentation and fusion for adolescent idiopathic scoliosis (AIS) are described with multiple biologic and biomechanical correlations attributed. This retrospective study aims to determine our rate of pseudoarthrosis and PJK in posterior spinal fusion for AIS, along with analysing the influence of autograft and allograft bone volume. Methods Immediate and 12‐month post‐operative radiographs of 78 patients treated for AIS were analysed along with late complications to a minimum of 2 years. Proximal kyphosis was determined by measuring and comparing the angle between the upper instrumented vertebra and upper instrumented vertebra + 2 for both immediate and 12‐month post‐operative radiographs. Spinal fusion was determined using an accepted grading scale on the 12‐month radiograph. These findings were correlated with known surgical variables in bone grafting technique. Results There was one case of PJK and no cases of pseudoarthrosis. Three patients showed a defect in the fusion mass but were still suggestive of fusion. The rates of fusion and PJK were not significantly different when using different allograft volumes or incorporating autograft. Conclusion Relatively low rates of PJK following AIS correction were observed compared to the literature. Rates were not increased with the use of proximal autograft. The amount of allograft used did not affect fusion rates either.