Related Experiment Video
Updated: Aug 25, 2025
Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic
Tomoyuki Asada1, Kousei Miura1, Masao Koda1
1Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.
Background:
Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK.
Methods:
We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (-).
Results:
PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (-) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, p = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK.
Conclusions:
Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD.
