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Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis.

Publication ,  Journal Article
Rabinovich, EP; Snyder, MH; McClure, JJ; Buell, TJ; Smith, JS; Shaffrey, CI; Buchholz, AL
Published in: Neurosurgery
July 15, 2021

BACKGROUND: Proximal junctional kyphosis (PJK) is a common postoperative complication after adult spinal deformity (ASD) surgery and may manifest with neurological decline, worsening spinal deformity, and spinal instability, which warrant reoperation. Rates of PJK may be as high as 69.4% after ASD surgery. OBJECTIVE: To evaluate the efficacy of junctional tethers for PJK prophylaxis after multilevel instrumented surgery for ASD with minimum 2-yr follow-up. METHODS: Single-center retrospective analysis of adult patients (age ≥18 yr) who underwent ASD surgery with index operations performed between November 2010 and June 2016 and achieved minimum 2-yr follow-up. Patients with ASD were subdivided into 3 treatment cohorts based on institutional protocol: no tether (NT), polyethylene tether-only (TO), and tether with crosslink (TC). PJK was defined as a proximal junctional angle (PJA) >10° and 10° greater than the corresponding preoperative measurement. Patient demographics, operative details, standard radiographic scoliosis measurements (including PJA and assessment of PJK), and complications were analyzed. RESULTS: Of 184 patients, 146 (79.3%) achieved minimum 2-yr follow-up (mean = 45 mo; mean age = 67 yr; 67.8% women). PJK rates reported for the NT, TO, and TC cohorts were 60.7% (37/61), 35.7% (15/42), and 23.3% (10/43), respectively. PJK rates among TC patients were significantly lower than NT (P = .01601). CONCLUSION: Junctional tethers with crosslink significantly reduced the incidence of PJK and revisions for PJK among ASD patients treated with long-segment posterior instrumented fusions who achieved minimum 2-yr follow-up.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

July 15, 2021

Volume

89

Issue

2

Start / End Page

227 / 235

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Scoliosis
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Polyethylene
  • Neurology & Neurosurgery
  • Male
  • Kyphosis
  • Humans
 

Citation

APA
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ICMJE
MLA
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Rabinovich, E. P., Snyder, M. H., McClure, J. J., Buell, T. J., Smith, J. S., Shaffrey, C. I., & Buchholz, A. L. (2021). Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis. Neurosurgery, 89(2), 227–235. https://doi.org/10.1093/neuros/nyab123
Rabinovich, Emily P., M Harrison Snyder, Jesse J. McClure, Thomas J. Buell, Justin S. Smith, Christopher I. Shaffrey, and Avery L. Buchholz. “Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis.Neurosurgery 89, no. 2 (July 15, 2021): 227–35. https://doi.org/10.1093/neuros/nyab123.
Rabinovich EP, Snyder MH, McClure JJ, Buell TJ, Smith JS, Shaffrey CI, et al. Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis. Neurosurgery. 2021 Jul 15;89(2):227–35.
Rabinovich, Emily P., et al. “Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis.Neurosurgery, vol. 89, no. 2, July 2021, pp. 227–35. Pubmed, doi:10.1093/neuros/nyab123.
Rabinovich EP, Snyder MH, McClure JJ, Buell TJ, Smith JS, Shaffrey CI, Buchholz AL. Posterior Polyethylene Tethers Reduce Occurrence of Proximal Junctional Kyphosis After Multilevel Spinal Instrumentation for Adult Spinal Deformity: A Retrospective Analysis. Neurosurgery. 2021 Jul 15;89(2):227–235.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

July 15, 2021

Volume

89

Issue

2

Start / End Page

227 / 235

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Scoliosis
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Polyethylene
  • Neurology & Neurosurgery
  • Male
  • Kyphosis
  • Humans