Strap stabilization for proximal junctional kyphosis prevention in instrumented posterior spinal fusion

Rodríguez-Fontán, Francisco; Reeves, Bradley J; Noshchenko, Andriy; Ou-Yang, David; Kleck, Christopher; Cain, Christopher M.; Walt, Evalina Burger-Van der; Patel, Vikas V.

doi:10.1007/s00586-020-06291-0

Cited by 25 publications

(27 citation statements)

References 24 publications

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Section: Discussionmentioning

confidence: 99%

“…The publications by Rodriguez-Fontan et al and Viswanathan et al analyzed above demonstrate that this procedure may be safe and effective in the osteopenic and osteoporotic population. 25,26 In addition to supplemental procedures such as posterior tethers and cement augmentation, precise alignment goals are crucial for the prevention of junctional complications. Line et al demonstrated in a propensity score matched analysis of 625 ASD patients that using surgical implants and avoiding overcorrection were necessary to prevent PJF in a general population.…”

Section: Discussionmentioning

confidence: 99%

“…Rodriguez-Fontan et al evaluated the success of Mersilene tape at the UIV and UIV þ 1 with results stratified by diagnosis of osteoporosis. 25 Compared to patients without use of this augmented stabilization, the group of patients with Mersilene tape demonstrated decreased risk of PJK when stratified by presence of osteoporosis, odds ratio ¼ 0.13 (95% confidence interval 0.01; 1.2), P ¼ .06. Despite the increased incidence of PJK in the control group, there was no increased need for revision surgery.…”

Section: The Effect Of Posterior-tension Band Supplementationmentioning

confidence: 92%

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A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

Echt

Ranson

Steinberger

et al. 2020

Global Spine Journal

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Study Design: Systematic review Objectives: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-known complications after long-segment fusions in the thoracolumbar spine of osteoporotic patients. Recent advances in anti-resorptive and anabolic medications, instrumentation, surgical technique, and cement augmentation have all aided in the avoidance of junctional kyphosis. In this article, current literature on the prevention of PJK and PJF in the osteoporotic spine is reviewed. Methods: A systematic literature review was conducted using the PubMed/MEDLINE and Embase databases in order to search for the current preventive treatment methods for PJK and PJF published in the literature (1985 to present). Inclusion criteria included (1) published in English, (2) at least 1-year mean and median follow-up, (3) preoperative diagnosis of osteoporosis, (4) at least 3 levels instrumented, and (5) studies of medical treatment or surgical techniques for prevention of junctional kyphosis. Results: The review of the literature yielded 7 studies with low levels of evidence ranging from level II to IV. Treatment strategies reviewed addressed prophylaxis against ligamentous failure, adjacent vertebral compression fracture, and/or bone-implant interface failure. This includes studies on the effect of osteoporosis medication, cement augmentation, multi-rod constructs, and posterior-tension band supplementation. The role of perioperative teriparatide therapy maintains the highest level of evidence. Conclusions: Perioperative teriparatide therapy represents the strongest evidence for preventive treatment, and further clinical trials are warranted. Use of cement augmentation, sublaminar tethers, and multi-rod constructs have low or insufficient evidence for recommendations. Future guidelines for adult spinal deformity correction may consider bone mineral density–adjusted alignment goals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: The Effect Of Posterior-tension Band Supplementationmentioning

confidence: 92%

See 1 more Smart Citation

A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

Echt

Ranson

Steinberger

et al. 2020

Global Spine Journal

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“…I recently read with great interest the article titled "Strap Stabilization for Proximal Junctional Kyphosis Prevention in Instrumented Posterior Spinal Fusion" by Rodriguez-Fontan et al [1]. The idea of using Mersilene tape band to prevent proximal junctional kyphosis is brilliant.…”

Section: Lettermentioning

confidence: 99%

Letter to the Editor concerning "Strap stabilization for proximal junctional kyphosis prevention in instrumented posterior spinal fusion" by Rodriguez-Fontan F, et al. (Eur Spine J; [2020]: 1287–1296, https://doi.org/10.1007/s00586-020-06,291-0)

Erşen

2020

Eur Spine J

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“…13 Additional surgical procedures such as ligament augmentation, which involves the wire or Mersiline tape stabilization of the posterior elements at upper vertebral levels, have also been described. 14,15 When PJK and PJF occur, patients frequently undergo revision surgery, with some series reporting up to 57% of patients with PJK or PJF undergoing revision. 12 Additionally, revision of PJK is the most common indication for fixation spanning the cervical spine through the pelvis.…”

Section: Introductionmentioning

confidence: 99%

Failures in Thoracic Spinal Fusions and Their Management

et al. 2021

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Instrumented fixation and fusion of the thoracic spine present distinct challenges and complications including pseudarthrosis and junctional kyphosis. When complications arise, morbidity to the patient can be significant, involving neurologic injury, failure of instrumentation constructs, as well as iatrogenic spinal deformity. Causes of fusion failure are multifactorial, and incompletely understood. Most likely, a diverse set of biomechanical and biologic factors are at the heart of failures. Revision surgery for thoracic fusion failures is complex and often requires revision or extension of instrumentation, and frequently necessitates complex soft tissue manipulation to manage index level injury or to augment the changes of fusion.

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Strap stabilization for proximal junctional kyphosis prevention in instrumented posterior spinal fusion

Cited by 25 publications

References 24 publications

A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

Letter to the Editor concerning "Strap stabilization for proximal junctional kyphosis prevention in instrumented posterior spinal fusion" by Rodriguez-Fontan F, et al. (Eur Spine J; [2020]: 1287–1296, https://doi.org/10.1007/s00586-020-06,291-0)

Failures in Thoracic Spinal Fusions and Their Management

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