Medical Journal of The Islamic Republic of Iran (MJIRI)

  Abstract

  Background: To evaluate proximal junctional segment changes in Adolescent Idiopathic

  Scoliosis(AIS) the posterior spinal fusion and also instrumentation also and

  finding of probable risk factors, were all considered in this study.

  Methods: We retrospectively reviewed radiographs of 121 consecutive patients

  who underwent posterior spinal fusion for AIS from T3 or below, with a mean follow-

  up of 32.8 months(range,24-83). All coronal and sagittal measurements including

  the proximal junctional kyphosis (PJK)angle recorded on standing anteroposterior

  and lateral radiographs preoperative, early postoperative and on follow-up radiographs.

  The data were analyzed using the Spss 10.0 software. Dependent(paired)

  samples student t-test was used for analysis between the groups

  Results: There was PJK angle above normal for the same junctional segment preoperatively in 13 patients (10.7%) and the incidence of the PJK postoperatively was

  7.4% (9 patients, 7 female and 2 male), all detected until 2 years postoperation.The

  mean increase in the PJK angle from pre-operation until 6 weeks postoperation was

  5.9° (range,0-13°)(P=0.02) and until 2 years post operation was 14.3° (range, 2-

  16°)(p=0.000). The mean proximal junctional angle increased 1.6° until 2 years postoperation in non-PJK group(n=112).

  Conclusion: The prevalence of Proximal Junctional Kyphosis was low and a

  silent radiographic problem. In some cases is preventable with perfect pre-operative

  planning. There is no specific demographic or radiographic variables or instrumentation

  types associated with developing PJK .