Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis

Praveen V. Mummaneni, Paul Park, Kai Ming Fu, Michael Y. Wang, Stacie Nguyen, Virginie Lafage, Juan S. Uribe, John Ziewacz, Jamie Terran, David O. Okonkwo, Neel Anand, Richard Fessler, Adam S. Kanter, Frank Lamarca, Vedat Deviren, R. Shay Bess, Frank J. Schwab, Justin S. Smith, Behrooz A. Akbarnia, Gregory M. MundisChristopher I. Shaffrey

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND: Proximal junctional kyphosis (PJK) is a known complication after spinal deformity surgery. One potential cause is disruption of posterior muscular tension band during pedicle screw placement. OBJECTIVE: To investigate the effect of minimally invasive surgery (MIS) on PJK. METHODS: A multicenter database of patients who underwent deformity surgery was propensity matched for pelvic incidence (PI) to lumbar lordosis (LL) mismatch and change in LL. Radiographic PJK was defined as proximal junctional angle >10°. Sixty-eight patients made up the circumferential MIS (cMIS) group, and 68 were in the hybrid (HYB) surgery group (open screw placement). RESULTS: Preoperatively, there was no difference in age, body mass index, PI-LL mismatch, or sagittal vertical axis. The mean number of levels treated posteriorly was 4.7 for cMIS and 8.2 for HYB (P

Original languageEnglish (US)
Pages (from-to)101-108
Number of pages8
JournalNeurosurgery
Volume78
Issue number1
DOIs
StatePublished - Sep 22 2015
Externally publishedYes

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Lordosis
Kyphosis
Cohort Studies
Minimally Invasive Surgical Procedures
Muscle Tonus
Incidence
Body Mass Index
Databases

Keywords

  • Adult spinal deformity
  • Hybrid surgery
  • Kyphosis
  • Minimally invasive spine surgery
  • Spinal fusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis. / Mummaneni, Praveen V.; Park, Paul; Fu, Kai Ming; Wang, Michael Y.; Nguyen, Stacie; Lafage, Virginie; Uribe, Juan S.; Ziewacz, John; Terran, Jamie; Okonkwo, David O.; Anand, Neel; Fessler, Richard; Kanter, Adam S.; Lamarca, Frank; Deviren, Vedat; Bess, R. Shay; Schwab, Frank J.; Smith, Justin S.; Akbarnia, Behrooz A.; Mundis, Gregory M.; Shaffrey, Christopher I.

In: Neurosurgery, Vol. 78, No. 1, 22.09.2015, p. 101-108.

Research output: Contribution to journalArticle

Mummaneni, PV, Park, P, Fu, KM, Wang, MY, Nguyen, S, Lafage, V, Uribe, JS, Ziewacz, J, Terran, J, Okonkwo, DO, Anand, N, Fessler, R, Kanter, AS, Lamarca, F, Deviren, V, Bess, RS, Schwab, FJ, Smith, JS, Akbarnia, BA, Mundis, GM & Shaffrey, CI 2015, 'Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis', Neurosurgery, vol. 78, no. 1, pp. 101-108. https://doi.org/10.1227/NEU.0000000000001002
Mummaneni, Praveen V. ; Park, Paul ; Fu, Kai Ming ; Wang, Michael Y. ; Nguyen, Stacie ; Lafage, Virginie ; Uribe, Juan S. ; Ziewacz, John ; Terran, Jamie ; Okonkwo, David O. ; Anand, Neel ; Fessler, Richard ; Kanter, Adam S. ; Lamarca, Frank ; Deviren, Vedat ; Bess, R. Shay ; Schwab, Frank J. ; Smith, Justin S. ; Akbarnia, Behrooz A. ; Mundis, Gregory M. ; Shaffrey, Christopher I. / Does minimally invasive percutaneous posterior instrumentation reduce risk of proximal junctional kyphosis in adult spinal deformity surgery? A propensity-matched cohort analysis. In: Neurosurgery. 2015 ; Vol. 78, No. 1. pp. 101-108.
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AU - Mummaneni, Praveen V.

AU - Park, Paul

AU - Fu, Kai Ming

AU - Wang, Michael Y.

AU - Nguyen, Stacie

AU - Lafage, Virginie

AU - Uribe, Juan S.

AU - Ziewacz, John

AU - Terran, Jamie

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AU - Bess, R. Shay

AU - Schwab, Frank J.

AU - Smith, Justin S.

AU - Akbarnia, Behrooz A.

AU - Mundis, Gregory M.

AU - Shaffrey, Christopher I.

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N2 - BACKGROUND: Proximal junctional kyphosis (PJK) is a known complication after spinal deformity surgery. One potential cause is disruption of posterior muscular tension band during pedicle screw placement. OBJECTIVE: To investigate the effect of minimally invasive surgery (MIS) on PJK. METHODS: A multicenter database of patients who underwent deformity surgery was propensity matched for pelvic incidence (PI) to lumbar lordosis (LL) mismatch and change in LL. Radiographic PJK was defined as proximal junctional angle >10°. Sixty-eight patients made up the circumferential MIS (cMIS) group, and 68 were in the hybrid (HYB) surgery group (open screw placement). RESULTS: Preoperatively, there was no difference in age, body mass index, PI-LL mismatch, or sagittal vertical axis. The mean number of levels treated posteriorly was 4.7 for cMIS and 8.2 for HYB (P

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