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Saygin Kamaci H. Gokhan Demirkiran Rustam Jalilov Muharrem Yazici

THE RATE OF PROXIMAL JUNCTIONAL KYPHOSIS IN DUAL GROWING ROD TREATMENT WITH PEDICLE SCREWS AS PROXIMAL ANCHOR. Hacettepe University Spine Study Group Ankara/TURKEY. Saygin Kamaci H. Gokhan Demirkiran Rustam Jalilov Muharrem Yazici. Proximal Junctional Kyphosis (PJK).

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Saygin Kamaci H. Gokhan Demirkiran Rustam Jalilov Muharrem Yazici

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  1. THE RATE OF PROXIMAL JUNCTIONAL KYPHOSIS IN DUAL GROWING ROD TREATMENT WITH PEDICLE SCREWS AS PROXIMAL ANCHOR Hacettepe University Spine Study Group Ankara/TURKEY Saygin Kamaci H. Gokhan Demirkiran Rustam Jalilov Muharrem Yazici

  2. ProximalJunctionalKyphosis (PJK) • One of the potential implant-related complication of growing rod treatment • Incidence; 7- 56 % • Risk factors: • Greater thoracic kyphosis, • Greater proximal thoracic scoliosis • More proximal level of lower instrumented vertebra • Proximal anchor other than • Pedicle screw construct • Age

  3. AIM • Find out the, rate of PJK in our series treated with standard surgical sechnique • Find predisposed risk factors • Proportion of this ratio with measurement methods

  4. Materials & Methods • 37 children (22 female, 15 male) • Idiopathic (10) • Congenital (11) • Syndromic (5) • Myelomeningocele(7) • Neuromuscular (3) • Proximal ligamentous and capsular structures were protected during the index surgery and re-exposures • Follow-up time; 63 month ( 24- 104 ) • Age at time of index operation; 73 month (45- 138) • Number of lenghts; 9 (3-14)

  5. PJK : An angle ≥10° increase between the immediate post-op and final follow up values • 4 screw : 33 • 3 screw + 2 hook : 1 • 2screw + 2 hook : 3

  6. GSSG tecnique (PJK1) - Onelevelcephaladtoupperinstrumentedvertebraandlowerendplate of theupperinstrumentedvertebra • SKAGGS tecnique(PJK2) • Upperendplate of thevertebratwolevelcephalad toupperinstrumentedvertebraandlowerendplate of thevertebratwolevelcaudaltotheupperinstrumentedvertebra

  7. Results • Overall PJK rate was 7% • 2 patients (6%) were revealed with PJK1 method • 3 patients (9%) were revelead with PJK2 method • There is no statistical difference between the two methods (p =?)

  8. Complications • 6/37 (16%) patients had screw pull out or loosening • 2/6 developed PJK

  9. Conclusion • One of the potential implant-related complication of growing rod treatment • With careful surgical technique - rate • Different measurment techniques – does not have a significant increase effect on the PJK rates • Revision of the GSSG measurement technique does not seem to be revised

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