{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:42Z","timestamp":1787015862528,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T00:00:00Z","timestamp":1656288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BE2017606"],"award-info":[{"award-number":["BE2017606"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772422"],"award-info":[{"award-number":["81772422"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Growing rods surgery is the mainstay of treatment for early\u2010onset scoliosis (EOS) while proximal junctional kyphosis (PJK) is one of the most commonly reported postoperative complications. We sought to investigate the impact of the location of upper instrumented vertebra (UIV) in relation to the sagittal apex on proximal junctional kyphosis in EOS after traditional growing rods (GRs) treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 102 EOS patients who received traditional growing rods treatment with a follow\u2010up of at least 2\u2009years between 2009 and 2020 were retrospectively reviewed. Radiographic measurements were performed before and after the index surgery and at the latest follow\u2010up. We investigated the coronal Cobb angle and spinopelvic parameters of the whole spine. The location of the UIV, apex, lower instrumented vertebra (LIV), inflection vertebra (IV), the number and distance of UIV\u2010apex, LIV\u2010apex and IV\u2010apex were also recorded. Risk factors for PJK were analyzed by logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PJK was observed in 21 patients (20.6%) during the follow\u2010up period. The PJK group showed a younger age at the index surgery (5.9\n                      <jats:italic>vs.<\/jats:italic>\n                      7.1\u2009years,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.042), more lengthening procedure times (5.0\n                      <jats:italic>vs.<\/jats:italic>\n                      4.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.032), larger preoperative coronal Cobb angle (82.0\n                      <jats:italic>vs.<\/jats:italic>\n                      75.6\u00b0,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.038), higher correction rate (51.2%\n                      <jats:italic>vs.<\/jats:italic>\n                      44.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.047) and larger postoperative proximal junctional angle (PJA) (13.9\n                      <jats:italic>vs.<\/jats:italic>\n                      5.5\u00b0,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.001) than the non\u2010PJK group. The ratio of the number and distance from UIV\u2010apex to IV\u2010apex also differed significantly between the two groups. The logistic regression revealed that age at the index surgery\u00a0\u2264\u20097\u2009years, the ratio of the number from UIV\u2010 apex to IV\u2010 apex\u00a0\u2264\u20090.6 and the ratio of the distance from UIV\u2010 apex to IV\u2010 apex\u00a0\u2264\u20090.6 were independent risk factors for postoperative PJK.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Besides younger age, a closer location of UIV relative to the sagittal apex is identified to be an independent risk factor of postoperative PJK. Selection of UIV at a relatively farther location away from the sagittal apex might help prevent occurrence of PJK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.13380","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T09:39:06Z","timestamp":1656495546000},"page":"1695-1702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Relook into the Risk Factors of Proximal Junctional Kyphosis in Early Onset Scoliosis Patients: Does the Location of Upper Instrumented Vertebra in Relation to the Sagittal Apex Matter?"],"prefix":"10.1111","volume":"14","author":[{"given":"Bo","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshuang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Qian","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zezhang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7181-877X","authenticated-orcid":false,"given":"Xu","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jspd.2017.12.012"},{"key":"e_1_2_7_3_1","first-page":"S38","article-title":"The natural history of early\u2010onset scoliosis","volume":"39","author":"Karol LJ","year":"2019","journal-title":"JBJS"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0709"},{"key":"e_1_2_7_5_1","first-page":"1","article-title":"Outcomes of growing rods in a series of early\u2010onset scoliosis patients with neurofibromatosis type","volume":"1","author":"Bouthors C","year":"2020","journal-title":"J Neurosurg: Spine"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000432"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000614"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v12.i8.584"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-020-00200-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02267-y"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000266"},{"issue":"9","key":"e_1_2_7_12_1","first-page":"1","article-title":"Low pelvic incidence is associated with proximal junctional kyphosis in patients treated with growing rods","volume":"41","author":"Carender 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early\u2010onset congenital scoliosis","volume":"57","author":"Sun X","year":"2019","journal-title":"Chin J 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