Related Experiment Video
Updated: May 12, 2026
06:45
Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Proximal junctional kyphosis and proximal junctional failure
Robert A Hart1, Ian McCarthy, Christopher P Ames
1Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR 97239, USA. hartro@ohsu.edu
Neurosurgery Clinics of North America
|April 9, 2013
Summary
Proximal junctional failure (PJF) is a serious complication after adult spinal deformity surgery, distinct from kyphosis. Identifying risk factors and refining surgical strategies are key to preventing this mechanical failure and its consequences.
Area of Science:
- Orthopedic Surgery
- Spinal Deformity Correction
- Biomechanical Engineering
Background:
- Proximal junctional failure (PJF) is a significant complication following adult spinal deformity surgery.
- PJF involves mechanical failure and can lead to neurologic injury and revision surgery.
- It must be differentiated from proximal junctional kyphosis, a recurrent deformity with less clinical impact.
Purpose of the Study:
- To highlight the distinction between PJF and proximal junctional kyphosis.
- To identify risk factors associated with PJF.
- To discuss strategies for preventing PJF in adult spinal deformity surgery.
Main Methods:
- Review of literature on adult spinal deformity surgery outcomes.
- Analysis of risk factors contributing to PJF.
- Discussion of current and potential surgical and perioperative strategies.
Main Results:
- PJF represents mechanical failure, unlike the recurrent deformity of kyphosis.
- Identified risk factors include patient age, severity of sagittal deformity, and extent of surgical realignment.
- Current surgical and perioperative techniques may require refinement to mitigate PJF.
Conclusions:
- PJF is a critical complication requiring careful management and prevention strategies.
- Addressing identified risk factors is crucial for improving surgical outcomes.
- Future advancements in surgical and perioperative care are necessary to reduce the incidence of PJF.
Related Concept Videos
01:27Mitral Valve Prolapse I: Introduction
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
01:23Degenerative Disc Disease ll: Pathophysiology
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
01:16Bones of the Lower Limb: Femur and Patella
The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the neck...
01:24Bone Formation by Endochondral Ossification
Bone formation, or ossification, begins around the sixth to seventh week of embryonic development. Most bones develop from a cartilaginous template through the process of endochondral ossification. Cartilage formation begins when clusters of mesenchymal cells differentiate into chondrocytes. These chondrocytes proliferate rapidly and secrete an extracellular matrix that becomes encased in a membrane called the perichondrium. The resulting cartilage model provides a template that resembles the...
01:29Bone Formation by Intramembranous Ossification
Intramembranous ossification is one of the two processes involved in the development of bones within an embryo. The flat bones of the face, most of the cranial bones, and the clavicles are formed via this process. During intramembranous ossification, the bones develop directly from sheets of undifferentiated mesenchymal connective tissue.
The process begins when mesenchymal cells in the embryonic skeleton gather together and differentiate into osteogenic cells, which then develop into...
The process begins when mesenchymal cells in the embryonic skeleton gather together and differentiate into osteogenic cells, which then develop into...
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...