Clinical Incidence of PJK/ASD in Adult Deformity Surgery: A Comparison of Rigid Fixation and Semirigid Fixation-Rigid.

Proximal junctional kyphosis (PJK) and adjacent segment degeneration (ASD) are important causes of reoperation for adult spinal deformity (). Reducing junctional complications can improve outcomes and cost-effectiveness of treatment. Rigid fixation is associated with significant proximal junctional pathology, but no clinical evidence indicates that less rigid fixation may reduce PJK. In lumbar degeneration, semirigid fixation has been associated with implant loosening, nonunion, and revision surgery. Rigid fixation is more reliable than semirigid fixation for management of spinal deformity.