Postoperative proximal junctional kyphosis correlated with thoracic inlet angle in Lenke 5c adolescent idiopathic scoliosis patients following posterior surgery

Abstract

Abstract Background Proximal junctional kyphosis is a common complication after posterior fusion in patients with adolescent idiopathic scoliosis and is correlated with postoperative changes of thoracic kyphosis. In lenke 5c patients, higher postoperative LL and spontaneous change of TK may produce an effect on final PJK. However, no studies has been performed to evaluate the correlation of PJK with thoracocervical parameters in patients with AIS. Methods Data from 98 patients who underwent posterior fusion for Lenke 5C AIS with 2 years of follow-up were retrospectively reviewed. Patients in the extended fusion group underwent fusion at levels higher than upper-end vertebra + 2 (n = 38), and those in the thoracolumbar/lumbar (TL/L) fusion group underwent fusion at UEV + 2 or lower (n = 60). Results During an average follow-up of 38.1 months, 23 of 98 patients developed PJK. The extended fusion group had a higher incidence of PJK than the TL/L fusion group (14/38 vs. 9/60, respectively; P = 0.01) and a significantly greater decrease in thoracic kyphosis than the TL/L group (P 71° are more likely to develop PJK. Additionally, extended fusion in patients with Lenke 5C may increase the risk of PJK.

Keywords

• Proximal junctional kyphosis
• Thoracic inlet angle
• Adolescent idiopathic scoliosis
• Sagittal alignment
• Thoracolumbar/lumbar curve