{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:55:59Z","timestamp":1785372959946,"version":"3.55.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Rate of neurological deficits in patients with PJK\/F after adult spinal deformity (ASD) surgery is understudied. In patients undergoing reoperation for proximal junctional kyphosis\/failure (PJK\/F) after adult spinal deformity (ASD) surgery, we sought to: 1) report the rate of neurological deficit, 2) describe these deficits, and 3) discuss improvement rates after reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study (2009\u201321) included ASD patients with:\u2009\u2265\u2009five-level fusion, sagittal\/coronal deformity, and\u2009&gt;\u20092-year follow-up. PJK was defined as 10\u00ba Cobb angle of the\u00a0upper instrumented vertebra (UIV)\u2013UIV\u2009+\u20092, and 10\u00ba increase from preoperative, while PJF was catastrophic PJK requiring reoperation due to screw pullout\/fracture. Primary outcome was the presence of neurological deficits and\/or worsened motor exam at the time of PJK\/F diagnosis, description of deficits, and improvement after reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 238 ASD patients, 47(19.7%) underwent reoperation for PJK\/F (mean age: 69.6\u2009\u00b1\u20099.4\u00a0years; mean instrumented levels: 9.4\u2009\u00b1\u20092.7) at a median of 15.6\u00a0months (IQR: 9.8\u201325.5). New motor deficits were seen in 15\/47(31.9%) patients at the time of PJK\/F diagnosis, and 3\u00a0(6.4%) endorsed incontinence. Neurological deficits occurred in 8\/29\u00a0(24.1%) PJK and 7\/18\u00a0(44.4%) PJF patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.147). Distal motor strength was 0\/5 in 1\u00a0(6.7%), 3\/5 in 5 (33.3%), and 4\/5 in 9\u00a0(60.0%). Of 15 patients with new motor deficits, 5\u00a0(33%) immediately returned-to-baseline, 5\u00a0(33%) improved but not to baseline, 3\u00a0(20%) remained unchanged, and 2 (13%) worsened within 3\u00a0months of reoperation. At the most recent follow-up (median: 3.9\u00a0years), 13\/15\u00a0(86.7%) patients had no deficits, and 2\u00a0(13.3%) improved but not to baseline. Notably, 1 patient without neurological deficit preoperatively developed 4\/5 motor exam following PJK surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients reoperated for PJK\/F, 32% had motor deficits and 6% had bladder incontinence. Immediately post-surgery, 33% returned-to-baseline, at last follow-up, 87% returned-to-baseline. These results can help patients, families, and surgeons appreciate long-term neurologic function after reoperation for PJK\/F.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01309-x","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:36:30Z","timestamp":1771432590000},"page":"1277-1287","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neurologic deficits due to proximal junctional kyphosis after adult spinal deformity surgery: how often do they happen and do they improve?"],"prefix":"10.1007","volume":"14","author":[{"given":"Hani","family":"Chanbour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander T.","family":"Lyons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren","family":"Jonzzon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyan","family":"Younus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir M.","family":"Abtahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron F.","family":"Stephens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2951-2942","authenticated-orcid":false,"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"1309_CR1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1093\/neuros\/nyz454","volume":"87","author":"MM Safaee","year":"2020","unstructured":"Safaee MM, Ames CP, Smith JS (2020) Epidemiology and socioeconomic trends in adult spinal deformity care. 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Dr. Stephens received institutional research support from Globus (ongoing) and Stryker (past). Dr. Abtahi received institutional research support from Stryker Spine. No other perceived conflict of interest by any of the listed authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Waived due to the retrospective nature of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Vanderbilt University Medical Center (IRB#220,894).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"IRB approval"}}]}}