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Updated: Jul 26, 2025

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Patient Optimization for the Prevention of Proximal Junctional Kyphosis
Brendan F Judy1, Jovanna A Tracz2, Safwan Alomari2
1Johns Hopkins University School of Medicine, Baltimore, MD, USA bjudy1@jhmi.edu.
Abstract:
Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-recognized challenges of surgery for adult spinal deformity (ASD). Multiple risk factors have been identified for PJK/PJF, including osteoporosis, frailty, neurodegenerative disease, obesity, and smoking. Several surgical techniques to mitigate risk of PJK/PJF have been identified; however, patient optimization is also critical. This review summarizes the data behind these 5 risk factors (osteoporosis, frailty, neurodegenerative disease, obesity, and smoking) and details the related recommendations for patients undergoing surgery for ASD.
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