Proximal junctional kyphosis in Lenke C5 curves. A comparison between anterior and posterior surgery
DOI:
https://doi.org/10.15417/263Keywords:
Adolescent idiopathic scoliosis, Lenke 5C. Anterior approach. Posterior approach. Proximal junctional kyphosisAbstract
Abstract
Background: Sagittal balance is critical for long-term results in the surgical handling of adolescent idiopathic scoliosis. Proximal junctional kyphosis could be defined as a radiographic findings in the fused and mobile spine transition in asymptomatic patients.
Objective: To compare post-surgical proximal junctional kyphosis in Lenke C5 curves with two different surgical techniques: anterior and posterior instrumentation.
Methods: Retrospective, controlled, non-randomized study of 37 patients with Lenke C5 adolescent idiopathic scoliosis, with short fusion from end-vertebra to end-vertebra. Group 1: 18 patients with anterior instrumented arthrodesis, and Group 2: 19 patients with posterior instrumented arthrodesis. The radiographic sagittal parameters measured were: 1) plumbline from the C7, 2) junctional kyphosis, 3) thoracic kyphosis, and 4) lumbar lordosis; with a minimum follow-up of two years.
Results: Group 1: increase of junctional kyphosis between the preoperative period and a two-year follow-up, 6.27° (p = 0.0002). The incidence of pathologic junctional kyphosis was 17%. Group 2: increase of junctional kyphosis between the preoperative period and the follow-up, 4.63° (p = 0.0004). The incidence of pathologic junctional kyphosis was 16%.
Conclusion: There were no significant differences between groups in the incidence of pathologic junctional kyphosis.
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