Our Summary

This research paper studies the risk factors for two types of spinal deformities: proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). The researchers looked back at the medical records of 160 patients who underwent a specific type of spinal surgery, and followed their recovery for at least 2 years.

They found that PJK developed in about 17% of the patients around 17 months after surgery, and PJF in about 18% of the patients around 3 months after surgery. The risk factors for developing PJK included having a high body mass index (being overweight). The risk factors for developing PJF included being older, having osteoporosis, having the uppermost part of the spine fused at a certain level, and having a greater bend in the spine before surgery.

In simpler terms, this research has identified certain things that can increase a patient’s chance of having these spinal deformities after surgery. These risk factors can be used to better predict who might develop these complications and potentially help in developing strategies to prevent them.

FAQs

  1. What are the risk factors for developing proximal junctional kyphosis (PJK) after spinal surgery?
  2. What are the risk factors for developing proximal junctional failure (PJF) after spinal surgery?
  3. How can the identification of these risk factors help in preventing spinal deformities after surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal fusion is to maintain a healthy weight and strengthen their bones through proper nutrition and exercise to reduce the risk of developing complications such as proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Additionally, patients should follow their post-operative care instructions closely and attend all follow-up appointments to monitor their recovery progress. It is important to communicate any changes or concerns with their healthcare team to address any potential issues promptly.

Suitable For

Patients who are typically recommended spinal fusion are those who have chronic back pain, spinal deformities such as scoliosis or kyphosis, spinal instability, spinal fractures, herniated discs, or degenerative disc disease. Spinal fusion is often recommended when more conservative treatments such as physical therapy, medication, or injections have not provided relief. Additionally, patients who have conditions such as spinal tumors, infections, or spinal stenosis may also be candidates for spinal fusion surgery.

It is important for patients to discuss their symptoms and medical history with a healthcare provider to determine if spinal fusion is the best treatment option for their specific condition. Additionally, patients should be aware of the potential risks and complications associated with spinal fusion surgery, including infection, nerve damage, and failure of the fusion to fully heal. Patients with certain risk factors, such as those identified in the research paper mentioned above, may require additional monitoring and precautions before and after surgery to reduce the likelihood of developing complications.

Timeline

Before spinal fusion surgery, a patient typically experiences chronic back or neck pain, weakness or numbness in the arms or legs, difficulty walking, and limited range of motion. They may have tried non-surgical treatments such as physical therapy, medications, and injections with little success.

After spinal fusion surgery, the patient will typically spend a few days in the hospital recovering. They will gradually start physical therapy to strengthen their muscles and improve flexibility. Pain medication may be needed for several weeks or months. It can take several months to a year for the spine to fully fuse and for the patient to return to normal activities.

However, as the research paper indicates, there is a risk of developing complications such as PJK or PJF after spinal fusion surgery. These complications can lead to further pain and limited mobility, requiring additional treatments or surgeries. It is important for patients to be aware of these risks and work closely with their healthcare provider to monitor their recovery and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion in light of this research include:

  1. What is my individual risk for developing proximal junctional kyphosis (PJK) or proximal junctional failure (PJF) after spinal fusion surgery?
  2. How can I minimize my risk for PJK and PJF based on the identified risk factors such as body mass index, age, osteoporosis, level of fusion, and pre-surgery spinal bend?
  3. What steps can I take before and after surgery to reduce the likelihood of developing these complications?
  4. Are there any specific exercises or lifestyle changes I should consider to improve my overall spinal health and reduce my risk for PJK and PJF?
  5. How will you monitor and follow up on my recovery to catch any signs of PJK or PJF early on?
  6. What are the treatment options if I do develop PJK or PJF post-surgery?
  7. Are there any additional precautions or considerations I should keep in mind given my individual risk factors for these complications?
  8. Could alternative treatment options or surgical techniques potentially lower my risk for PJK and PJF?
  9. How common are PJK and PJF in patients undergoing spinal fusion surgery, and what is the typical course of treatment for these complications?
  10. Are there any additional resources or support groups available for patients who may be at higher risk for PJK and PJF?

Reference

Authors: Park SJ, Lee CS, Chung SS, Lee JY, Kang SS, Park SH. Journal: Neurosurgery. 2017 Feb 1;80(2):279-286. doi: 10.1227/NEU.0000000000001240. PMID: 28173513