The Impact of Global Alignment and Proportion Score and Bracing on Proximal Junctional Kyphosis in Adult Spinal Deformity. Issue 3 (April 2023)
- Record Type:
- Journal Article
- Title:
- The Impact of Global Alignment and Proportion Score and Bracing on Proximal Junctional Kyphosis in Adult Spinal Deformity. Issue 3 (April 2023)
- Main Title:
- The Impact of Global Alignment and Proportion Score and Bracing on Proximal Junctional Kyphosis in Adult Spinal Deformity
- Authors:
- Lord, Elizabeth L.
Ayres, Ethan
Woo, Dainn
Vasquez-Montes, Dennis
Parekh, Yesha
Jain, Deeptee
Buckland, Aaron
Protopsaltis, Themistocles - Abstract:
- Study Design: Retrospective chart review. Objective: The goal of this study is to examine the relationship between global alignment and proportion (GAP) score and postoperative orthoses with likelihood of developing proximal junctional kyphosis (PJK). Methods: Patients who underwent thoracic or lumbar fusions of ≥4 levels for adult spinal deformity (ASD) with 1-year post-operative alignment x-rays were included. Chart review was conducted to determine spinopelvic alignment parameters, PJK, and reoperation. Results: A total of 81 patients were included; baseline and 1-year postoperative alignment did not differ between patients with and without PJK. There was no PJK in 53.1%, 29.6% had PJK from 10-20°, and 17.3% had severe PJK over 20° (sPJK). At baseline, 80% of patients had severely disproportioned GAP, 13.75% moderate, 6.25% proportioned. GAP improved across the population, but improved GAP was not associated with sPJK. Greater correction of the upper instrumented vertebra to pelvic angle (UIV-PA) was associated with a larger PJK angle (PJKA) change (R = -0.28) as was the 1 year T1-upper instrumented vertebra (T1-UIV) angle (R = 0.30), both P < .05. GAP change was not correlated with PJKA change. Postoperative orthoses were used in 46% of patients and did not impact sPJK. Conclusions: There was no correlation between PJK and GAP or change in GAP. Greater correction of UIV-PA and larger postop T1-UIV was associated with greater PJKA change; suggesting that the greaterStudy Design: Retrospective chart review. Objective: The goal of this study is to examine the relationship between global alignment and proportion (GAP) score and postoperative orthoses with likelihood of developing proximal junctional kyphosis (PJK). Methods: Patients who underwent thoracic or lumbar fusions of ≥4 levels for adult spinal deformity (ASD) with 1-year post-operative alignment x-rays were included. Chart review was conducted to determine spinopelvic alignment parameters, PJK, and reoperation. Results: A total of 81 patients were included; baseline and 1-year postoperative alignment did not differ between patients with and without PJK. There was no PJK in 53.1%, 29.6% had PJK from 10-20°, and 17.3% had severe PJK over 20° (sPJK). At baseline, 80% of patients had severely disproportioned GAP, 13.75% moderate, 6.25% proportioned. GAP improved across the population, but improved GAP was not associated with sPJK. Greater correction of the upper instrumented vertebra to pelvic angle (UIV-PA) was associated with a larger PJK angle (PJKA) change (R = -0.28) as was the 1 year T1-upper instrumented vertebra (T1-UIV) angle (R = 0.30), both P < .05. GAP change was not correlated with PJKA change. Postoperative orthoses were used in 46% of patients and did not impact sPJK. Conclusions: There was no correlation between PJK and GAP or change in GAP. Greater correction of UIV-PA and larger postop T1-UIV was associated with greater PJKA change; suggesting that the greater alignment correction led to greater likelihood of failure. Postoperative orthoses had no impact on PJK. … (more)
- Is Part Of:
- Global spine journal. Volume 13:Issue 3(2023)
- Journal:
- Global spine journal
- Issue:
- Volume 13:Issue 3(2023)
- Issue Display:
- Volume 13, Issue 3 (2023)
- Year:
- 2023
- Volume:
- 13
- Issue:
- 3
- Issue Sort Value:
- 2023-0013-0003-0000
- Page Start:
- 651
- Page End:
- 658
- Publication Date:
- 2023-04
- Subjects:
- deformity -- degenerative -- sagittal alignment
Spine -- Diseases -- Periodicals
Spine -- Diseases -- Treatment -- Periodicals
Spine -- Abnormalities -- Periodicals
Spine -- Surgery -- Periodicals
616.73 - Journal URLs:
- http://www.thieme.com/ ↗
- DOI:
- 10.1177/21925682211001812 ↗
- Languages:
- English
- ISSNs:
- 2192-5682
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 25790.xml