Table 1 Summary of cases
From: Sagittal balance is more than just alignment: why PJK remains an unresolved problem
Case. No. | Age/Sex | Smoker | BMI | Indication for Index Surgery | Index Surgery | UIV Fixation | Time to PJK diagnosis | Mode of Failure | PJK surgery | Fall prior | Assistive devise | CCMI | Other co-morbidities |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 68/F | Yes | 40.9 | Kyphoscoliosis | PSF T10 to Pelvis, TLIF L3-L4 | bilateral pedicle screws | 8 months | Fracture of T9-T10 with cord compression | T9-T10 laminectomy, extension of fusion T4-T11 | No | No | 11 | None |
2 | 64/M | Yes | 19.7 | Stenosis | PSF L3 to L5 | bilateral pedicle screws | 18 months | Fracture of L3 | PSO L3, PSF T11 to pelvis | Yes | Cane | 11 | CVA, Loss of reflexes below knee |
3 | 58/M | No | 33.9 | Multilevel stenosis | PSF L3 to Pelvis | bilateral pedicle screws | 17 months | Fracture of L3 | AIF L5-S1, Ponte osteotomies, PSF T10 to pelvis | Yes | No | 4 | CSM post ACDF |
4 | 63/F | No | 25.9 | Multilevel stenosis | PSF L2 to L5 | bilateral pedicle screws | 21 months | Compression of L2 with complete loss of L1-L2 interspace | Extension to T10 | No | Wheelchair | 10 | CVA, Cauda equina requiring emergent decompression, Diabetic neuropathy |
5 | 65/F | Yes | 34.9 | ASF L4-S1, PSF T10 to Pelvis | bilateral pedicle screws | 11 months | Compression Fracture T11 | Extension of fusion to T3 | Yes | Walker | 9 | Diabetic neuropathy, Frequent falls, post bilateral TKA, ORIF L ankle | |
6 | 70/F | No | 25.7 | Kyphoscoliosis | ASF, PSF T10 to Pelvis | bilateral pedicle screws | 12 months | Compression Fracture T9 | Extension of fusion to T3 | No | Cane | 7 | Cataracts |
1 month after 1st PJK | Pull out of claw construct fracturing T4 to T8 laminae | Extension of Fusion T2 to T12 | |||||||||||
7 | 52/F | Yes | 25.6 | Degenerative scoliosis, stenosis | PSF, L2 to sacrum | bilateral pedicle screws | 64 months | Kyphosis at L1-L2 impingement of screws into disc space | TLIF L1-L2, PSF L1-L2 | Yes | Crutches | 8 | Diabetic neuropathy |
8 | 64/M | No | 31.0 | Flatback S/P L3-L5 PSF | ASF L5-S1, PSF T9 to Sacrum | bilateral pedicle screws | 18 months | T8-T9 Listhesis | Extension of fusion to T2 | Yes | Walker | 8 | CVA, Neuropathy, Cataracts (removed), CSM post laminectomy, Frequent falls, post THA dislocation |
9 | 57/F | No | 30.5 | Flatback S/P L3-L5 laminectomies | PSF T11 to Pelvis | bilateral pedicle screws | 25 months | Compression Fracture T9 - T10 | Extension of fusion to T3 | No | No | 9 | TIAs, Diabetic neuropathy, Cataracts, Frequent falls, post bilateral TKA, multiple foot surgeries |
10 | 60/M | Yes | 19.3 | Kyphoscoliosis | ASF L4-S1, PSF T10 to Pelvis | bilateral pedicle screws | 82 months | Fracture of T9, T8-T9 spondylolisthesis | PSF T4 to T12 | Yes | Walker | 9 | CVA, Sensory neuropathy, Glaucoma, Frequent falls, post multiple revisions of bilateral TKA |
14 months after 1st PJK | Pull out of claw construct fracturing T3 lamina | Extension of Fusion T1 to T10 | |||||||||||
11 | 58/M | No | 34.7 | Degenerative scoliosis, stenosis | PSF T10 to Pelvis, TLIF L5-S1 | bilateral pedicle screws | 1 month | T9-T10 Listhesis | PSF T4 to T10 | Yes | No | 6 | DTs, Neuropathy, Frequent falls, alcoholic, had DTs after index surgery |
12 | 75/F | No | 29.0 | Degenerative scoliosis S/P L2-L3 PDSF | PSF T10 to Pelvis, TLIF L5-S1 | bilateral pedicle screws | 27 months | Screw pull out | Extension to T4 | Yes | No | 5 | None |
13 | 62/F | Yes | 30.0 | Flatback deformity S/P L2-LS1 PDSF | PSF L2 to S1 | bilateral pedicle screws | 12 months | Fracture L1 | Extension to T10 | No | Cane | 6 | Tremors, Multiple foot surgeries |
38 months after 1st PJK | T9-T10 fracture with erosion of screws into disc | Removal of instrumentation, PSF T4 to L2 | |||||||||||
14 | 69/F | Yes | 26.5 | Adjacent segment degeneration S/P L3 to L5 PSF | Extension of fusion L1 to S1 | bilateral pedicle screws | 1 month | L1-L2 listhesis | Extension from T10 to S1 | No | No | 7 | None |
15 | 57/F | No | 40.8 | Degenerative scoliosis, stenosis | PSF L2 to S1 | bilateral pedicle screws | 92 months | L1-L2 listhesis | Extension from T10 to S1 | No | Cane | 5 | Parkinson's disease |
16 | 63/F | No | 23.2 | Adjacent segment stenosis S/P L1 to S1 PSDF | PSF T9 to L3 | bilateral pedicle screws | 7 months | Posterior lysis of T9 and T10 | Removal of instrumentation, PSF T4 to L3 | Yes | Cane | 8 | Cataract, CSM post C3 to T1 ACDF |
17 | 73/F | No | 36.4 | Scoliosis | PSF T6 to Sacrum | bilateral hooks | 80 months | Fracture T6 | Removal of instrumentation, PSF T3 to L1 | No | No | 9 | Cataract |
18 | 61/M | Yes | 32.5 | Scoliosis | PSF T8 to Sacrum | bilateral pedicle screws | 11 months | Fracture T8 | Removal of instrumentation, PSF T4 to Pelvis | No | Walker | 7 | Polymyositis |
19 | 72/M | No | 36.8 | Scoliosis | PSF T11 to L3 | bilateral pedicle screws | 23 months | T10-T11 listhesis | Removal of instrumentation, PSF T8 to T11 | No | Walker | 6 | CSM post laminoplasty, Frequent falls |
41 months after 1st PJK | T7-T8 listhesis | Removal of instrumentation T9-L1, PSF T2 to T9 | |||||||||||
20 | 78/F | No | 39.9 | Scoliosis | PSF L1 to S1 | bilateral pedicle screws | 14 months | Fracture T12 | Extension of Fusion to T8 | No | No | 7 | Metabolic encephalopathy, Cataract |
21 | 71/F | Yes | 26.5 | Degenerative Scoliosis | PSF L2-L3 | bilateral pedicle screws | 45 months | L1-L2 collapse and localized scoliosis | Extension to T10 | No | Cane | 10 | Cataract (removed), Cervical osteomyelitis with cord compromise |
22 | 75/F | No | 30.4 | Scoliosis | PSF T4 to Pelvis | bilateral hooks | 2 months | Hook pull-out with T4-T6 laminar fractures | Extension to T2 | No | No | 10 | Cataract |
23 | 69/M | No | 27.4 | Post-laminectomy instability | ASF L3 to S1, PSF L2 to S1 | bilateral pedicle screws | 1 month | Compression Fracture of L2 with screw pullout | Removal of instrumentation, PSF T10 to L1 | No | No | 6 | Diabetic neuropathy |
24 | 55/F | No | 38.0 | Adjacent segment stenosis S/P L2 to S1 PSDF | PSF T10 to Pelvis, TLIF L2-L3, L5-S1 | bilateral pedicle screws | 9 months | Compression Fracture T10 | Extension to T3 | Yes | No | 8 | CSM post ACDF |
25 | 70/F | No | 35.5 | Stenosis | PDSF L2-L5 | bilateral pedicle screws | 10 months | Compression of L2 | PSF T10 to Pelvis | Yes | Cane | 7 | Metabolic encephalopathy, Cataract, Frequent falls |
5 months after 1st PJK | Compression Fracture T9 | Extension to T2 | |||||||||||
26 | 62/F | No | 21.4 | Adjacent segment stenosis S/P L3 to L5 PSDF | ASF L2 to L5, Extension of fusion to T10 | bilateral hooks | 3 months | Fracture T10 | Extension to T2 | No | Cane | No | CSM post ACDF, Neuropathy, Frequent falls |
27 | 73/F | No | 20.6 | Scoliosis | PSF T10 to Pelvis | bilateral pedicle screws | 4 months | T10 compression fracture | PSF T7 to T12 | Yes | Walker | Yes | Mild cognitive impairment, Benign thoracic tumor S/P excision |
28 | 65/F | No | 21.1 | Scoliosis | PSF T11 to S1 | bilateral pedicle screws | 22 months | T10-T11 listhesis, nonunion L5-S1 | AIF L3 to S1, PSF T10 to Pelvis | No | No | No | Seizures, Eye surgery |
29 | 33/M | Yes | 26.7 | Scoliosis | PSF L1 TO L4 | bilateral pedicle screws | 22 months | Compression of T12 | Removal of instrumentation, PSF T10 to Pelvis | No | Cane | No | Chronic dropfoot |