BACKGROUND CONTEXT: Proximal junctional failure (PJF) is a recognized complication of @entity85 surgery. @entity810 ( @entity810 ) has recently been demonstrated to be 5.6% in the @entity85 ( @entity85 ) population. The incidence and rate of return to the operating room for @entity810 have not been specifically investigated in individuals with sagittal imbalance. PURPOSE: The purpose of this study was to report the incidence of @entity810 in @entity1 with preoperative sagittal imbalance and the rate of return to the operating room for @entity810 . STUDY DESIGN/SETTING: This study is based on a retrospective review of prospectively collected database of @entity85 @entity1 . @entity1 SAMPLE: One hundred seventy-three consecutive @entity1 were included with preoperative sagittal imbalance according to one of the following common parameters: sagittal vertical axis (SVA) greater than 50 mm, global sagittal alignment greater than 45  , or pelvic incidence minus @entity1515 greater than 10  . OUTCOME MEASURES: Outcome measure was presence and/or absence of @entity810 defined as @entity174 at the upper instrumented vertebra (UIV) or UIV+1, failure of UIV fixation, 15   or more proximal junctional kyphosis, or need for extension of instrumentation within 6 months of surgery. METHODS: We performed radiographic measurements on X-rays at preoperative, immediate postoperative, and 6-month follow-up visits. The @entity810 rate was reported for the entire @entity1 population with preoperative sagittal imbalance. @entity810 incidence was calculated postoperatively for each of the accepted sagittal balance parameters and/or formulas. @entity1 with persistent postoperative sagittal imbalance were compared with the sagittally balanced group. We also assessed for threshold values. RESULTS: @entity810 was observed in 60 of 173 @entity1 (35%) and was least common in fusions with the UIV in the upper thoracic (UT) spine (p=.035). Of those who developed @entity810 , 21.7% required surgery. @entity3161 15   or more was the most common form of @entity810 in fusions to the UT spine but least likely to need revision (p=.014). The most common mode of failure in lower thoracic (LT) or lumbar (L) fusions was UIV @entity174 . Postoperative SVA less than 50 mm was a significant risk factor for @entity810 (p=.009). CONCLUSIONS: @entity810 is more common in @entity1 with preoperative sagittal imbalance (35%) than the general @entity85 @entity1 population, and 37% of those with @entity810 require revision. It is least common when the UIV is in the UT spine, compared with the LT or L spine. Sagittal balance correction to an SVA 50 mm or less was a significant risk factor in @entity1 with preoperative sagittal imbalance.

Acute proximal junctional failure in XXXX with preoperative sagittal imbalance.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENT'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity1515 :: ('MESH:D008141', 'Disease') :: ['lumbar lordosis'] @entity3161 :: ('MESH:D020511', 'Disease') :: ['Proximal junctional kyphosis'] @entity810 :: ('MESH:D058186', 'Disease') :: ['APJF', 'Acute PJF'] @entity85 :: ('MESH:D009140', 'Disease') :: ['spinal deformity', 'adult spinal deformity', 'ASD', 'adult deformity']
@entity1 :: (9606,Species) :: ['patients']
