OBJECTIVE: Radiographic evaluation of proximal and distal junctional kyphosis in patients undergoing spinal fusion and different types of posterior instrumentation, in the surgical treatment for adolescent idiopathic scoliosis (AIS). METHOD: A retrospective review was done with radiographic evaluation of 34 patients who were submitted to spinal fusion with posterior instrumentation, divided as follows: 10 using only hooks (Group I), 13 hybrid fixation (screws and hooks) (Group II) and 11 using only pedicle screws (Group III) from June 1997 to December 2009. The study assessed the occurrence of junctional kyphosis both proximal and distal to the arthrodesis, in the preoperative, immediate postoperative periods, in the final follow up, and also in the late postoperative period, which was at least 12 months. RESULTS: Patients in group I showed lower value of thoracic kyphosis preoperatively, but the lumbar lordosis remained unchanged throughout evolution. Patients in group II and group III showed an increase in the assessed value of lumbar lordosis postoperatively. There was no significant difference in the occurrence of proximal junctional kyphosis among the three groups. Regarding the distal junctional kyphosis, there was a statistically significant increase in value between the preoperative and postoperative for groups II and III. CONCLUSION: Radiographic evaluation of the proximal and distal junctional kyphosis in patients who underwent arthrodesis and different types of instrumentation in the surgical treatment of adolescent idiopathic scoliosis, revealed the presence of preoperative proximal junctional kyphosis, which have not progressed to postoperative junctional deformity, and also complete absence of distal junctional abnormality.
Spine; Scoliosis; Spinal fusion; Adolescent
