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A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy.

Publication ,  Journal Article
Rabinovich, EP; Buell, TJ; Sardi, JP; Lazaro, BCR; Shaffrey, CI; Smith, JS
Published in: Oper Neurosurg (Hagerstown)
November 15, 2021

BACKGROUND: Proximal junctional kyphosis (PJK) rates may be as high as 69.4% after adult spinal deformity (ASD) surgery. PJK is one of the greatest unsolved challenges in long-segment fusions for ASD and remains a common indication for costly and impactful revision surgery. Junctional tethers may help to reduce the occurrence of PJK by attenuating adjacent-segment stress. OBJECTIVE: To report our experience and assess early safety associated with a novel "weave-tether technique" (WTT) for PJK prophylaxis in a large series of patients. METHODS: This single-center retrospective study evaluated consecutive patients who underwent ASD surgery including WTT between 2017 and 2018. Patient demographics, operative details, standard radiographic measurements, and complications were analyzed. RESULTS: A total of 71 patients (mean age 66 ± 12 yr, 65% women) were identified. WTT included application to the upper-most instrumented vertebrae (UIV) + 1 and UIV + 2 in 38(53.5%) and 33(46.5%) patients, respectively. No complications directly attributed to WTT usage were identified. For patients with radiographic follow-up (96%; mean duration 14 ± 12 mo), PJK occurred in 15% (mean 1.8 ± 1.0 mo postoperatively). Proximal junctional angle increased an average 4° (10° to 14°, P = .004). Rates of symptomatic PJK and revision for PJK were 8.8% and 2.9%, respectively. CONCLUSION: Preliminary results support the safety of the WTT for PJK prophylaxis. Approximately 15% of patients developed radiographic PJK, no complications were directly attributed to WTT usage, and the revision rate for PJK was low. These early results warrant future research to assess longer-term efficacy of the WTT for PJK prophylaxis in ASD surgery.

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Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

November 15, 2021

Volume

21

Issue

6

Start / End Page

393 / 399

Location

United States

Related Subject Headings

  • Spine
  • Spinal Fusion
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Kyphosis
  • Humans
  • Female
  • Aged
 

Citation

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Rabinovich, E. P., Buell, T. J., Sardi, J. P., Lazaro, B. C. R., Shaffrey, C. I., & Smith, J. S. (2021). A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy. Oper Neurosurg (Hagerstown), 21(6), 393–399. https://doi.org/10.1093/ons/opab305
Rabinovich, Emily P., Thomas J. Buell, Juan P. Sardi, Bruno C. R. Lazaro, Christopher I. Shaffrey, and Justin S. Smith. “A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy.Oper Neurosurg (Hagerstown) 21, no. 6 (November 15, 2021): 393–99. https://doi.org/10.1093/ons/opab305.
Rabinovich EP, Buell TJ, Sardi JP, Lazaro BCR, Shaffrey CI, Smith JS. A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy. Oper Neurosurg (Hagerstown). 2021 Nov 15;21(6):393–9.
Rabinovich, Emily P., et al. “A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy.Oper Neurosurg (Hagerstown), vol. 21, no. 6, Nov. 2021, pp. 393–99. Pubmed, doi:10.1093/ons/opab305.
Rabinovich EP, Buell TJ, Sardi JP, Lazaro BCR, Shaffrey CI, Smith JS. A Novel Weave Tether Technique for Proximal Junctional Kyphosis Prevention in 71 Adult Spinal Deformity Patients: A Preliminary Case Series Assessing Early Complications and Efficacy. Oper Neurosurg (Hagerstown). 2021 Nov 15;21(6):393–399.
Journal cover image

Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

November 15, 2021

Volume

21

Issue

6

Start / End Page

393 / 399

Location

United States

Related Subject Headings

  • Spine
  • Spinal Fusion
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Kyphosis
  • Humans
  • Female
  • Aged