Proximal junctional kyphosis and failure risk around the thoracolumbar junction: Impact of anterior malalignment, pelvic retroversion, and upper instrumented level selection
Mauricio Hansen, Lluis Vila, Aleksander Leszczynski, Carlos Aleman, Frank Meyer, Caroline Deck, Sleiman Haddad, Susana Núñez-Pereira, Ferran Pellisé, Anika Pupak, Ibrahim Obeid, Louis Boissière, Ahmet Alanay, Frank Kleinstück, Markus Loibl, Javier Pizones, Yann Philippe Charles, the European Spine S · 2026
Read Proximal junctional kyphosis and failure risk around the thoracolumbar junction: Impact of anterior malalignment, pelvic retroversion, and upper instrumented level selection by Mauricio Hansen, Lluis Vila, Aleksander Leszczynski, Carlos Aleman, Frank Meyer, Caroline Deck, Sleiman Haddad, Susana Núñez-Pereira, Ferran Pellisé, Anika Pupak, Ibrahim Obeid, Louis Boissière, Ahmet Alanay, Frank Kleinstück, Markus Loibl, Javier Pizones, Yann Philippe Charles, the European Spine S (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13158418.txt.
Description
Mauricio Hansen and co-authors asked why spinal fusion surgery fails at its top end, in a 2026 European Spine Study Group study. After adult deformity surgery, the spine can bend or break above the fused segment, a complication called proximal junctional kyphosis or failure. The team reviewed three hundred and fifty-one patients fused to the pelvis, split by where the fusion stopped, plus simulations of the constructs.
The complication struck about twenty-two percent in both groups. Patients who failed showed more forward misalignment and pelvic tilt compensation six weeks after surgery, though key measurements differed by group. The simulations explained why: chest-level constructs loaded the top vertebra mainly in compression, growing with forward offset, while lumbar-level ones loaded it in shear. Pelvic tilt barely relieved either. The authors conclude that where the fusion ends chooses the failure mechanism, not the risk.
Catalog record
| CREATOR | Mauricio Hansen, Lluis Vila, Aleksander Leszczynski, Carlos Aleman, Frank Meyer, Caroline Deck, Sleiman Haddad, Susana Núñez-Pereira, Ferran Pellisé, Anika Pupak, Ibrahim Obeid, Louis Boissière, Ahmet Alanay, Frank Kleinstück, Markus Loibl, Javier Pizones, Yann Philippe Charles, the European Spine S |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 43 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |