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Proximal Junctional Kyphosis and Proximal Junctional Failure Following Spinal Deformity Surgery

Mendoza-Lattes, Sergio MD

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Techniques in Orthopaedics: March 2021 - Volume 36 - Issue 1 - p 1
doi: 10.1097/BTO.0000000000000530
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The increasing burden of musculo-skeletal disorders in an aging population, also includes an increasing prevalence of symptomatic spinal deformity. Safer and more effective corrective procedures have been developed, and supported by an extensive body of work. Nevertheless, a significant number of patients result in proximal junctional kyphosis (PJK) and failures (PJF), some of the most common complications of spinal deformity surgery.

We are fortunate to present this Special Edition Symposium of Techniques in Orthopedic Surgery with manuscripts written by some of the world’s most prevalent thought leaders: first, we provide a framework with current definitions of PJK/PJF and epidemiology.1 These conditions are further described in the adolescent population2 and the economic impact of PJK/PJF is critically analyzed.3

When considering prevention strategies, we first look at risks factors inherent to the patient,4 and the problem of recurrent PJK.5 Surgical strategies to prevent PJK/PJF are discussed including soft landings, tension band augmentation6 and junctional cement augmentation.7

While this edition of Techniques in Orthopedic Surgery covers updated, current knowledge on PJK/PJF, further research is necessary to reduce the high prevalence of this problem.


1. Watanabe K, Yagi M, Fujita N, et al. Proximal junctional kyphosis and proximal junctional failure in the treatment for adult spinal deformity—definitions and epidemiology. Tech Orthop. 2021;36:2–6.
2. Ha AS, Park PJ, Levitsky MM, et al. Proximal junctional kyphosis following adolescent idiopathic scoliosis correction. Tech Orthop. 2021;36:7–11.
3. Theologis AA, Gussous YM, Berven SH. Economic impact of proximal junctional kyphosis. Tech Orthop. 2021;36:12–17.
4. Hauser SW. Proximal junctional kyphosis symposium: patient factors that can contribute to development of proximal junctional kyphosis. Tech Orthop. 2021;36:18–19.
5. York PJ, Kim HJ. Recurrent proximal junctional kyphosis. Tech Orthop. 2021;36:20–24.
6. Mehta VA, Wang TY, Sankey EW, et al. Prevention of proximal junctional kyphosis or failure: soft landings and tension band augmentation. Tech Orthop. 2021;36:30–34.
7. Martin CT. Prevention of proximal junctional kyphosis or failure: cement augmentation. Tech Orthop. 2021;36:25–29.
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