Instrumentation Failure in Adult Spinal Deformity Patients.
David P FalkRavi AgrawalBijan DehghaniRohit BhanSachin GuptaMunish C GuptaPublished in: Journal of clinical medicine (2024)
In recent years, advances in the surgical treatment of adult spinal deformity (ASD) have led to improved outcomes. Although these advances have helped drive the development of deformity surgery to meet the rising volume of patients seeking surgical treatment, many challenges have yet to be solved. Instrumentation failure remains one of the most common major complications following deformity surgery, associated with significant morbidity due to elevated re-operation rates among those experiencing mechanical complications. The two most frequently encountered subtypes of instrumentation failure are rod fracture (RF) and proximal junctional kyphosis/proximal junctional failure (PJK/PJF). While RF and PJK/PJF are both modes of instrumentation failure, they are two distinct entities with different clinical implications and treatment strategies. Considering that RF and PJK/PJF continue to represent a major challenge for patients with ASD and deformity surgeons alike, this review aims to discuss the incidence, risk factors, clinical impact, treatment strategies, preventive measures, and future research directions for each of these substantial complications.
Keyphrases
- risk factors
- end stage renal disease
- ejection fraction
- minimally invasive
- newly diagnosed
- autism spectrum disorder
- spinal cord
- prognostic factors
- coronary artery bypass
- type diabetes
- mental health
- patient reported outcomes
- attention deficit hyperactivity disorder
- metabolic syndrome
- spinal cord injury
- quality improvement
- skeletal muscle
- glycemic control
- hip fracture