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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
  1. PSDF posterior spinal decompression and fusion, PSF posterior spinal fusion, ASF anterior spinal fusion, TLIF transforaminal lumbar interbody fusion, CVA cerebrovascular accident, CSM cervical spondylotic myelopathy, ACDF anterior cervical discectomy and fusion, TKA total knee arthroplasty, ORIF open reduction internal fixation, THA total hip arthroplasty, DT delirium tremens