近端交界性后凸畸形与失败——诊断、预防及治疗
Proximal junctional kyphosis and failure-diagnosis, prevention, and treatment.
作者信息
Nguyen Ngoc-Lam M, Kong Christopher Y, Hart Robert A
机构信息
Department of Orthopaedic Surgery and Rehabilitation, Oregon Health and Science University, Mail Code OP31, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
出版信息
Curr Rev Musculoskelet Med. 2016 Sep;9(3):299-308. doi: 10.1007/s12178-016-9353-8.
Abstract
Technical advancements have enabled the spinal deformity surgeon to correct severe spinal mal-alignment. However, proximal adjacent segment pathology (ASP) remains a significant issue. Examples include proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Agreement on the definition, classification, and pathophysiology of PJK and PJF remains incomplete, and an understanding of the risk factors, means of prevention, and treatment of this problem remains to be elucidated. In general, PJK is a relatively asymptomatic radiographic diagnosis managed with patient reassurance and monitoring. On the other hand, PJF is characterized by mechanical instability, pain, and more severe kyphosis, with potential for neurologic compromise. Patients who develop PJF more often require revision surgery than those with PJK. This chapter will review the current understanding of PJK and PJF.
摘要
技术进步使脊柱畸形外科医生能够矫正严重的脊柱排列不齐。然而，近端相邻节段病变（ASP）仍然是一个重要问题。例如包括近端交界性后凸（PJK）和近端交界性失败（PJF）。关于PJK和PJF的定义、分类和病理生理学的共识仍不完整，对该问题的危险因素、预防方法和治疗的理解仍有待阐明。一般来说，PJK是一种相对无症状的影像学诊断，通过安抚患者和进行监测来处理。另一方面，PJF的特征是机械性不稳定、疼痛和更严重的后凸，有神经功能损害的可能性。发生PJF的患者比发生PJK的患者更常需要翻修手术。本章将回顾对PJK和PJF的当前认识。
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