SymposiumEconomic Impact of Proximal Junctional KyphosisTheologis, Alekos A. MD*; Gussous, Yazeed M. MD†; Berven, Sigurd H. MD*Author Information *Department of Orthopaedic Surgery, University of California—San Francisco (UCSF), San Francisco †El Camino Hospital, Mountain View, CA The authors declare that they have nothing to disclose. For reprint requests, or additional information and guidance on the techniques described in the article, please contact Sigurd H. Berven, MD, at [email protected] or by mail at Spine Division, Department of Orthopaedic Surgery, University of California—San Francisco, 500 Parnassus Avenue, MU West 3rd Floor, Room W321, San Francisco, CA 94143. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques. Techniques in Orthopaedics: March 2021 - Volume 36 - Issue 1 - p 12-17 doi: 10.1097/BTO.0000000000000470 Buy Metrics Abstract Proximal junctional kyphosis (PJK) is a common occurrence after posterior thoracolumbar instrumented spinal fusions for adult spinal deformity (ASD). Despite its relative frequency, PJK’s economic impact has only recently gained appreciation and attention. On the basis of the available literature, direct costs associated with revision surgery for PJK range from ∼$20,000 to $120,000. The average direct costs for revision operations for PJK in the lower thoracic spine are similar to the costs for revision operations for PJK in the upper thoracic spine. Variability in costs may be attributable to variations in surgical strategies and individual hospital’s postoperative care protocols and pricing. In the discussion to follow, the economic impact of PJK after operative intervention for ASD will be showcased by presenting it in the larger context of our health care system’s focus on value-based care, the health burden of ASD, and quality and costs associated with ASD operations. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.