{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:12:42Z","timestamp":1783660362030,"version":"3.55.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-recognised complications following long thoracolumbar fusion constructs and frequently require complex revision surgery. Achieving stable fixation and solid arthrodesis at proximal levels is particularly challenging in the setting of advanced degeneration and altered anatomy. This case review describes a hybrid fixation strategy incorporating cervical facet fixation to address these challenges.\n\nCase Report: A 76-year-old female presented 21 months after T4\u2013pelvis fusion with progressive PJF, resulting in upper thoracic kyphotic deformity, focal spinal stenosis, and progressive myelopathic symptoms. Imaging demonstrated a fracture at T4, grade 2 T3\u20134 anterolisthesis, and significant kyphosis with compromise of the spinal canal. The patient underwent revision surgery consisting of C2\u2013T4 posterior fusion with decompression and posterior column osteotomies. A hybrid construct was utilised, including cervical lateral mass fixation, thoracic pedicle fixation, and intervening zero-profile cervical facet fixation. Cervical facet fixation was employed to provide supplemental stabilisation while preserving posterior fusion surface area and accommodating degenerative anatomy without extensive osteophyte resection.\n\nConclusion: At 2-year follow-up, the patient demonstrated maintained sagittal alignment and radiographic evidence of solid arthrodesis without hardware failure or progression of deformity.\n\nKeywords: Proximal junctional failure, proximal junctional kyphosis, revision spine surgery, cervical facet fixation, long-segment spinal fusion, sagittal alignment.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7666","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:12:35Z","timestamp":1783656755000},"page":"286-291","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Posterior Fixation Incorporating Cervical Facet Fixation for the Treatment of Proximal Junctional Failure"],"prefix":"10.13107","volume":"16","author":[{"given":"Micah W","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, SpineONE\/Orthopaedics Northeast, Fort Wayne, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:12:36Z","timestamp":1783656756000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/hybrid-posterior-fixation-incorporating-cervical-facet-fixation-for-the-treatment-of-proximal-junctional-failure\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7666","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}