In Brief:
Proximal junctional kyphosis is a form of adjacent segment pathology that occurs in 17% to 39% of cases after spinal deformity surgery. Although multifactorial in etiology, older patients with prior fusions to the sacrum, combined anteroposterior surgery, thoracoplasty, upper instrumented vertebra at T1–T3, and those without anatomical restoration of thoracic kyphosis, are at higher risk and should be followed closely.
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