Instrumentation techniques to prevent proximal junctional kyphosis and proximal junctional failure in adult spinal deformity correction-a systematic review of biomechanical studies

摘要

BACKGROUND CONTEXT: Correction of adult spinal deformity (ASD) by long segment instrumented spinal fusion is an increasingly common surgical intervention. However, it is associated with high rates of complications and revision surgery, especially in the elderly patient population. The high construct stiffness of instrumented thoracolumbar spinal fusion has been postulated to lead to a higher incidence of proximal junctional kyphosis (PJK) and failure (PJF). Several cadaveric biomechanical studies have reported on surgical techniques to reduce the incidence of PJF/PJK. As yet, no overview has been made of these biomechanical studies.