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European Spine Journal

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01-01-2015 | Original Article

Osteotomies in proximal junctional kyphosis in the cervicothoracic area

Authors: R. Cecchinato, P. Berjano, R. Bassani, C. Lamartina

Published in: European Spine Journal | Special Issue 1/2015

Abstract

Introduction

Proximal junctional kyphosis (PJK) of the cervicothoracic spine is a deformity that can affect patients who have undergone long thoracolumbar instrumented fusion. Preoperative hyperkyphosis of the thoracic spine and changes of more than 30° in lumbar lordosis are independent risk factors for the onset of PJK.

Methods

When PJK occurs in the cervicothoracic spine, extension of the fusion with eventual application of osteotomy techniques is frequently necessary to treat symptomatic patients or in case a neurological deficit occurs. Ponte osteotomy and pedicle subtraction osteotomy (PSO) are the two most used techniques to restore a good cervicothoracic alignment, although they are still demanding procedures even for expert surgeons. In junctional fractures, a vertebral column resection can be performed to support the anterior column. Ponte osteotomy ideally restores 10° at each treated level, while PSO allows a segmental correction up to 30°–35°. Adequate preoperative planning is fundamental for outlining the correct surgery and choosing the appropriate osteotomy.

Conclusions

The aim of corrective surgery is to restore the cervicothoracic alignment, obtaining an adequate postoperative sagittal balance and decreasing the risk of further complications and new revision surgeries.

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Title: Osteotomies in proximal junctional kyphosis in the cervicothoracic area
Authors: R. Cecchinato
P. Berjano
R. Bassani
C. Lamartina
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3654-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Osteotomies in proximal junctional kyphosis in the cervicothoracic area

Abstract

Introduction

Methods

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Conclusions

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