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Updated: Jul 25, 2025

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Proximal Junctional Kyphosis Prevention Strategies Focused on Alignment
Mariah Balmaceno-Criss1, Daniel Alsoof1, Renaud Lafage2
1Department of Orthopedics, Brown University Warren Alpert Medical School, Providence, RI, USA.
Abstract:
Adult spinal deformity (ASD) is a complex pathology associated with spinal malalignment in the coronal, sagittal, and axial planes. Proximal junction kyphosis (PJK) is a complication of ASD surgery, affecting 10%-48% of patients, and can result in pain and neurological deficit. It is defined radiographically as a greater than 10° Cobb angle between the upper instrumented vertebrae and the 2 vertebrae proximal to the superior endplate. Risk factors are classified according to the patient, surgery, and overall alignment, but it is important to consider the interplay between various factors. This article reviews the risk factors of PJK and considers alignment-focused prevention strategies.
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