| Popis: |
BACKGROUND CONTEXT Proximal junction kyphosis (PJK) has been well documented with pedicle screws in AIS patients. In Scheuermann's kyphosis (SK), PJK has been reported with hybrid fixation in the presence of shorter fusions. The literature is deficient about PJK in SK with all pedicle screw constructs. PURPOSE To determine if the incidence of PJK is higher with pedicle screw fixation than hybrid. STUDY DESIGN/SETTING Multicenter ambispective review. PATIENT SAMPLE Eighty-four patients. OUTCOME MEASURES PJK, kyphosis. METHODS Xray and chart review of all SK patients operated with all pedicle screw (PS), hybrid fixation (HF), and anterior or posterior fusions with hybrid fixation (AP) were reviewed. Number of fusion levels, percent correction, UIV, LIV, pre and postop PJK, sagittal balance, and demographic data was collected. PJK was defined as more than 10°. Fisher's exact test, Kruskal-Wallis, Wilcoxon ranked sum test were used. RESULTS A total of 84 total patients: PS (n=29), HF (n=24), and AP (n=31). Median preop kyphosis was significantly higher in the AP compared to PS and HF (89vs. 77vs. 81.5, p CONCLUSIONS Incidence of PJK appears to be higher in SK compared to that reported in AIS. Patients with pedicle screw fixation appear to be at the highest risk. UIV at T3 or proximally has significantly lower PJK. |
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