51. Upper instrumented vertebra-femoral angle and correlation with proximal junctional kyphosis in adult spinal deformity.
- Author
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Wu, Hao-Hua, Chou, Dean, Hindoyan, Kevork, Guinn, Jeremy, Rivera, Joshua, Duan, Pingguo, Wang, Minghao, Xi, Zhuo, Li, Bo, Lee, Andrew, Burch, Shane, Mummaneni, Praveen, and Berven, Sigurd
- Subjects
Lumbar Vertebrae ,Thoracic Vertebrae ,Humans ,Kyphosis ,Spinal Fusion ,Retrospective Studies ,Adult ,Adult spinal deformity ,Proximal junctional kyphosis ,Surgical complication ,Patient Safety ,Clinical Research ,Rehabilitation ,Biomedical Engineering ,Clinical Sciences - Abstract
IntroductionAlthough matching lumbar lordosis (LL) with pelvic incidence (PI) is an important surgical goal for adult spinal deformity (ASD), there is concern that overcorrection may lead to proximal junctional kyphosis (PJK). We introduce the upper instrumented vertebra-femoral angle (UIVFA) as a measure of appropriate postoperative position in the setting of lower thoracic to pelvis surgical correction for patients with sagittal imbalance. We hypothesize that a more posterior UIV position in relation to the center of the femoral head is associated with an increased risk of PJK given compensatory hyperkyphosis above the UIV.MethodsIn this retrospective cohort study, adult patients undergoing lower thoracic (T9-T12) to pelvis correction of ASD with a minimum of 2-year follow-up were included. UIVFA was measured as the angle subtended by a line from the UIV centroid to the femoral head center to the vertical axis. Patients who developed PJK and those who did not were compared with preoperative and postoperative UIVFA as well as change between postoperative and preoperative UIVFA (deltaUIVFA).ResultsOf 119 patients included with an average 3.6-year follow-up, 51 (42.9%) had PJK and 24 (20.2%) had PJF. Patients with PJK had significantly higher postoperative UIVFA (12.6 ± 4.8° vs. 9.4 ± 6.6°, p = 0.04), deltaUIVFA (6.1 ± 7.6° vs. 2.1 ± 5.6°, p
- Published
- 2022