Cho Samuel K, Kim Yongjung J, Lenke Lawrence G
J Am Acad Orthop Surg. 2015 Jul;23(7):408-14. doi: 10.5435/JAAOS-D-14-00143. Epub 2015 May 21.
Proper understanding and restoration of sagittal balance is critical in spinal deformity surgery, including conditions such as adolescent idiopathic scoliosis and Scheuermann kyphosis. One potential complication following spinal reconstruction is proximal junctional kyphosis. The prevalence of proximal junctional kyphosis varies in the literature, and several patient- and surgery-related risk factors have been identified. To date, the development of proximal junctional kyphosis has not been shown to lead to a negative clinical outcome following spinal fusion for adolescent idiopathic scoliosis or Scheuermann kyphosis. Treatment options range from simple observation in asymptomatic cases to revision surgery with extension of the fusion proximally. Several techniques and technologies are emerging that seek to address and prevent proximal junctional kyphosis.
正确理解和恢复矢状面平衡在脊柱畸形手术中至关重要,包括青少年特发性脊柱侧凸和休门氏后凸等病症。脊柱重建术后的一个潜在并发症是近端交界性后凸。近端交界性后凸的患病率在文献中有所不同,并且已经确定了一些与患者和手术相关的风险因素。迄今为止,对于青少年特发性脊柱侧凸或休门氏后凸行脊柱融合术后,近端交界性后凸的发生尚未显示会导致不良临床结局。治疗选择范围从无症状病例的单纯观察到近端延长融合范围的翻修手术。正在出现几种旨在解决和预防近端交界性后凸的技术和工艺。