{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T20:05:50Z","timestamp":1769544350998,"version":"3.49.0"},"reference-count":25,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"1","license":[{"start":{"date-parts":[[2020,2,6]],"date-time":"2020-02-06T00:00:00Z","timestamp":1580947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T00:00:00Z","timestamp":1511913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjective\nThe aim of this study was to investigate the effect of distal fusion level selection on the distal junctional kyphosis (DJK) in Scheuermann kyphosis (SK) patients who underwent posterior fusion.\nMethods\nThirty-nine SK patients who underwent posterior fusion with a minimum follow-up of 3 years were retrospectively evaluated. According to the distal fusion level, patients were divided into 3 groups. Group S; lowest instrumented vertebra (LIV) was the sagittal stable vertebra (SSV), Group F; LIV was the first lordotic vertebra (FLV) and, Group L; LIV was the lower end vertebra (LEV). DJK was evaluated according to distal level selection.\nResults\nThoracic kyphosis (TK) decreased from 73.3\u00b0 (SD \u00b1 7.9\u00b0) to 39\u00b0 (SD \u00b1 8.7\u00b0) postoperatively, with a mean correction rate of 46% (SD \u00b1 13) (p &lt; 0.0001). In 11 patients, FLV and SSV was the same vertebra. In remaining 28 patients, 10 patients were in Group S, 15 patients were in Group F and 3 patients were in Group L. In Group S, none of them developed DJK, however, DJK was observed 9 of 15 patients in Group F. DJK was developed in all cases in Group L. There is a statistically higher risk for developing DJK when FLV or LEV was selected as LIV (p &lt; 0.05).\nConclusion\nSelecting SSV for the distal fusion level has been found to be effective for preventing DJK. Selecting distal fusion level proximal to SSV will increase the risk of DJK which may become symptomatic and require revision surgery.\nLevel of evidence\nLevel IV, therapeutic study.\nER -\n\nKeywords\n\n\n\tScheuermann kyphosis\n\tDistal junctional kyphosis\n\tSagittal stable vertebra\n\tFirst lordotic vertebra\n\tLower end vertebra<\/jats:p>","DOI":"10.1016\/j.aott.2017.11.012","type":"journal-article","created":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T09:05:59Z","timestamp":1514451959000},"page":"7-11","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"title":["Selection of distal fusion level in terms of distal junctional kyphosis in Scheuermann kyphosis. A comparison of 3 methods"],"prefix":"10.5152","volume":"52","author":[{"given":"Fatih","family":"D\u0130K\u0130C\u0130","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turgut","family":"AKGUL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerim","family":"SAR\u0130Y\u0130LMAZ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"KORKMAZ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okan","family":"OZKUNT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuneyt","family":"SAR","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Unsal","family":"DOMAN\u0130C","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,6]]},"reference":[{"issue":"4","key":"10.1016\/j.aott.2017.11.012_bib1","doi-asserted-by":"crossref","first-page":"383","DOI":"10.3233\/BMR-140483","article-title":"Scheuermann's 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A comparison of 3 methods","name":"articletitle","label":"Article Title"},{"value":"Acta Orthopaedica et Traumatologica Turcica","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.aott.2017.11.012","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}