{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:27:59Z","timestamp":1794324479333,"version":"4.9.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,19]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective of this study was to determine whether patient-specific precontoured rod (PCR) instrumentation is associated with lower rates of proximal junctional kyphosis (PJK) compared with manually contoured conventional rods (CRs) in adult spinal deformity (ASD) surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The data of ASD patients (age \u2265 18 years) undergoing posterior spinal instrumentation and fusion of a minimum of 5 levels were consecutively reviewed from 2016 to 2021. A propensity score\u2013matching algorithm was used to match patients undergoing instrumentation with PCRs (n = 80) to those treated with CRs (n = 210). The primary outcome was the rate of radiographic PJK at a minimum follow-up of 1 year. PJK was defined by two criteria: a postoperative proximal junctional sagittal angle (PJA) 1) \u2265 10\u00b0 and 2) at least 10\u00b0 greater than the preoperative measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Following propensity score matching, 160 patients were included in the study (80 per group). Patients demonstrated similar preoperative baseline characteristics and preoperative radiographic alignment. Preoperatively, the mean PJAs measured 9.24\u00b0 \u00b1 6.8\u00b0 and 8.8\u00b0 \u00b1 7.3\u00b0 for the PCR and CR groups, respectively (p = 0.751). At the most recent follow-up, the PCR and CR groups demonstrated mean PJAs of 11.6\u00b0 \u00b1 9.1\u00b0 and 10.8\u00b0 \u00b1 8.3\u00b0, respectively (p = 0.545). Ten (12.5%) patients experienced PJK in the PCR group compared to 16 (20%) patients in the CR group (p = 0.199). In patients with upper instrumented vertebrae in the lower thoracic region, 5 (11.1%) patients in the PCR group experienced PJK versus 12 (26.7%) patients in the CR group (p = 0.059). Furthermore, 7 (10.9%) patients in the PCR group experienced PJK compared to 14 (21.5%) patients in the CR group after including patients with fusion to the sacrum\/pelvis (p = 0.103).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Lower rates of PJK were observed in the PCR group when compared to the CR cohort. However, this relationship was not statistically significant. Future studies with longer-term follow-up and larger sample sizes are warranted to investigate the relationship between PCR instrumentation and PJK prophylaxis. While PCR technology alone is likely not a definitive solution for preventing PJK, its strength lies in enabling rigorous preoperative planning and thoughtful deformity correction strategies. When integrated into a comprehensive approach to patient optimization, alignment, and junctional control, PCRs may serve as a useful adjunct in mitigating PJK risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.spine251110","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:22:37Z","timestamp":1781655757000},"page":"423-428","source":"Crossref","is-referenced-by-count":0,"title":["Can patient-specific precontoured rod instrumentation reduce the rate of proximal junctional kyphosis for adult spinal deformity? A propensity score\u2013matched analysis"],"prefix":"10.3171","volume":"45","author":[{"given":"Michael W.","family":"Fields","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Greisberg","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin L.","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matan S.","family":"Malka","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cole","family":"Morrissette","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeshan M.","family":"Sardar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald A.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Columbia University Medical Center, The Och Spine Hospital at NewYork-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Semin Spine Surg","first-page":"100992","article-title":"Proximal junctional kyphosis in adult spinal deformity: an up-to-date review","volume":"34","author":"Alhammoud A","year":"2022","unstructured":"Alhammoud A, Korytkowski PD, Lavelle WF, Metkar US. Proximal junctional kyphosis in adult spinal deformity: an up-to-date review. Semin Spine Surg. 2022;34(4):100992. doi: 10.1016\/j.semss.2022.100992"},{"issue":"3","key":"b2","series-title":"J Neurosurg Spine","first-page":"324","article-title":"Sarcopenia in paraspinal muscle as a risk factor of proximal junctional kyphosis and proximal junctional failure after adult spinal deformity surgery","volume":"40","author":"Park JS","year":"2024","unstructured":"Park JS, Cho KJ, Kim JS, Park SJ, Baek H. Sarcopenia in paraspinal muscle as a risk factor of proximal junctional kyphosis and proximal junctional failure after adult spinal deformity surgery. J Neurosurg Spine. 2024;40(3):324\u2013330. doi: 10.3171\/2023.9.SPINE23531"},{"issue":"3","key":"b3","series-title":"Acta Orthop Traumatol Turc","first-page":"158","article-title":"Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: a systematic review and meta-analysis","volume":"56","author":"Han X","year":"2022","unstructured":"Han X, Ren J. Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: a systematic review and meta-analysis. Acta Orthop Traumatol Turc. 2022;56(3):158\u2013165. doi: 10.5152\/j.aott.2022.21255"},{"issue":"2","key":"b4","series-title":"Neurosurgery","first-page":"279","article-title":"Different risk factors of proximal junctional kyphosis and proximal junctional failure following long instrumented fusion to the sacrum for adult spinal deformity: survivorship analysis of 160 patients","volume":"80","author":"Park SJ","year":"2017","unstructured":"Park SJ, Lee CS, Chung SS, Lee JY, Kang SS, Park SH. Different risk factors of proximal junctional kyphosis and proximal junctional failure following long instrumented fusion to the sacrum for adult spinal deformity: survivorship analysis of 160 patients. 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Instrumentation techniques to prevent proximal junctional kyphosis and proximal junctional failure in adult spinal deformity correction: a systematic review of clinical studies. Global Spine J. 2022;12(6):1282\u20131296. doi: 10.1177\/21925682211034500"},{"key":"b7","series-title":"World Neurosurg","first-page":"179","article-title":"State of the evidence for proximal junctional kyphosis prevention in adult spinal deformity surgery: a systematic review of current literature","volume":"161","author":"Shlobin NA","year":"2022","unstructured":"Shlobin NA, Le N, Scheer JK, Tan LA. State of the evidence for proximal junctional kyphosis prevention in adult spinal deformity surgery: a systematic review of current literature. 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Spine Deform. 2014;2(3):219\u2013225. doi: 10.1016\/j.jspd.2014.01.003"},{"issue":"4","key":"b9","series-title":"J Spine Surg","first-page":"409","article-title":"Patient-specific spinal rods in adult spinal deformity surgery reduce proximal junctional failure: a review of patient outcomes and surgical technique in a prospective observational cohort","volume":"9","author":"Faulks CR","year":"2023","unstructured":"Faulks CR, Biddau DT, Munday NR, McKenzie DP, Malham GM. Patient-specific spinal rods in adult spinal deformity surgery reduce proximal junctional failure: a review of patient outcomes and surgical technique in a prospective observational cohort. J Spine Surg. 2023;9(4):409\u2013421. doi: 10.21037\/jss-23-85"},{"issue":"2","key":"b10","series-title":"Clin Spine Surg","first-page":"80","article-title":"Patient-specific rods for surgical correction of sagittal imbalance in adults: technical aspects and preliminary results","volume":"32","author":"Solla F","year":"2019","unstructured":"Solla F, Barrey CY, Burger E, Kleck CJ, Fi\u00e8re V. Patient-specific rods for surgical correction of sagittal imbalance in adults: technical aspects and preliminary results. Clin Spine Surg. 2019;32(2):80\u201386. doi: 10.1097\/BSD.0000000000000721"},{"issue":"1","key":"b11","series-title":"Orthop Traumatol Surg Res","first-page":"159","article-title":"Patient-specific rods for thoracic kyphosis correction in adolescent idiopathic scoliosis surgery: preliminary results","volume":"106","author":"Solla F","year":"2020","unstructured":"Solla F, Cl\u00e9ment JL, Cunin V, Bertoncelli CM, Fi\u00e8re V, Rampal V. Patient-specific rods for thoracic kyphosis correction in adolescent idiopathic scoliosis surgery: preliminary results. Orthop Traumatol Surg Res. 2020;106(1):159\u2013165. doi: 10.1016\/j.otsr.2019.07.027"},{"issue":"1","key":"b12","series-title":"Eur Spine J","first-page":"190","article-title":"Restoration of thoracic kyphosis in adolescent idiopathic scoliosis with patient-specific rods: did the preoperative plan match postoperative sagittal alignment?","volume":"32","author":"Thomas ES","year":"2023","unstructured":"Thomas ES, Boyer N, Meyers A, Aziz H, Aminian A. Restoration of thoracic kyphosis in adolescent idiopathic scoliosis with patient-specific rods: did the preoperative plan match postoperative sagittal alignment? 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Neurospine. 2023;20(3):876\u2013889. doi: 10.14245\/ns.2346566.283"},{"issue":"2 suppl","key":"b15","series-title":"Global Spine J","first-page":"40S","article-title":"Pre-operative planning in complex deformities and use of patient-specific UNiD\u2122 instrumentation","volume":"12","author":"Ou-Yang D","year":"2022","unstructured":"Ou-Yang D, Burger EL, Kleck CJ. Pre-operative planning in complex deformities and use of patient-specific UNiD\u2122 instrumentation. Global Spine J. 2022;12(2 suppl):40S\u201344S. doi: 10.1177\/21925682211055096"},{"issue":"3","key":"b16","series-title":"Spine Surg Relat Res","first-page":"256","article-title":"Utility of patient-specific rod instrumentation in deformity correction: single institution experience","volume":"4","author":"Sadrameli SS","year":"2020","unstructured":"Sadrameli SS, Boghani Z, Steele Iii WJ, Holman PJ. Utility of patient-specific rod instrumentation in deformity correction: single institution experience. 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Spine Deform. 2024;12(3):577\u2013585. doi: 10.1007\/s43390-023-00805-8"},{"issue":"S2","key":"b19","series-title":"Int J Spine Surg","first-page":"S38","article-title":"Proximal junctional kyphosis prevention strategies focused on alignment","volume":"17","author":"Balmaceno-Criss M","year":"2023","unstructured":"Balmaceno-Criss M, Alsoof D, Lafage R,  Proximal junctional kyphosis prevention strategies focused on alignment. Int J Spine Surg. 2023;17(S2):S38\u2013S46. doi: 10.14444\/8513"},{"issue":"1","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"62","article-title":"Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity surgery account for age?","volume":"41","author":"Lafage R","year":"2016","unstructured":"Lafage R, Schwab F, Challier V,  Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity surgery account for age? 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Feasibility study and preliminary results about 77 cases","volume":"2020","author":"Prost S","year":"2020","unstructured":"Prost S, Pesenti S, Farah K, Tropiano P, Fuentes S, Blondel B. Adult spinal deformities: can patient-specific rods change the preoperative planning into clinical reality? Feasibility study and preliminary results about 77 cases. Adv Orthop. 2020;2020:6120580. doi: 10.1155\/2020\/6120580"},{"issue":"1","key":"b23","series-title":"Global Spine J","first-page":"102","article-title":"Sarcopenia is an independent risk factor for proximal junctional disease following adult spinal deformity surgery","volume":"12","author":"Eleswarapu A","year":"2022","unstructured":"Eleswarapu A, O\u2019Connor D, Rowan FA,  Sarcopenia is an independent risk factor for proximal junctional disease following adult spinal deformity surgery. Global Spine J. 2022;12(1):102\u2013109. doi: 10.1177\/2192568220947050"},{"issue":"2","key":"b24","series-title":"J Korean Neurosurg Soc","first-page":"174","article-title":"Risk factors of proximal junctional kyphosis after multilevel fusion surgery: more than 2 years follow-up data","volume":"60","author":"Kim DK","year":"2017","unstructured":"Kim DK, Kim JY, Kim DY, Rhim SC, Yoon SH. Risk factors of proximal junctional kyphosis after multilevel fusion surgery: more than 2 years follow-up data. J Korean Neurosurg Soc. 2017;60(2):174\u2013180. doi: 10.3340\/jkns.2016.0707.014"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/45\/3\/article-p423.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/45\/3\/article-p423.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/45\/3\/article-p423.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:20:53Z","timestamp":1794324053000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/45\/3\/article-p423.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":24,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2026.1.spine251110","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,19]]}}}