{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:06:24Z","timestamp":1778299584775,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Several studies have reported incidence and risk factors for the development of proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS). However, there is little information regarding long-term follow-up after pedicle screw instrumentation (PSI) with rod derotation (RD) and direct vertebral rotation (DVR). Sixty-nine AIS patients who underwent deformity correction using PSI with RD and DVR were retrospectively analyzed in two groups according to the occurrence of PJK, with a minimum five-year follow-up, including a non-PJK group (n = 62) and PJK group (n = 7). Radiological parameters were evaluated at preoperative, postoperative, and last follow-up. Incidence for PJK was 10.1% (7\/69 patients), with a mean 9.4-year follow-up period. The thoracolumbar\/lumbar curve (TL\/L curve) was proportionally higher in the PJK group. The proximal compensatory curve was significantly lower in the PJK group than in the non-PJK group preoperatively (p = 0.027), postoperatively (p = 0.001), and at last follow-up (p = 0.041). The development of PJK was associated with the TL\/L curve pattern, lower preoperative proximal compensatory curve, and over-correction of the proximal curve for PSI with RD and DVR. Therefore, careful evaluation of compensatory curves as well as of the main curve is important to prevent the development of PJK in the treatment of AIS.<\/jats:p>","DOI":"10.3390\/jcm10225351","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T09:16:11Z","timestamp":1637140571000},"page":"5351","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Incidence and Radiological Risk Factors of Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis Following Pedicle Screw Instrumentation with Rod Derotation and Direct Vertebral Rotation: A Minimum 5-Year Follow-Up Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-9585","authenticated-orcid":false,"given":"Hong Jin","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-6954","authenticated-orcid":false,"given":"Jae Hyuk","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Korea University Guro Hospital, Korea University, Seoul 08308, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-1063","authenticated-orcid":false,"given":"Dong-Gune","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se-Il","family":"Suk","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Woo","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Korea University Guro Hospital, Korea University, Seoul 08308, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2758-0012","authenticated-orcid":false,"given":"Sang-Il","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang-Sup","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-301X","authenticated-orcid":false,"given":"Woojin","family":"Cho","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Department of Orthopedic Surgery, Albert Einstein College of Medicine, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.2106\/JBJS.RVW.18.00059","article-title":"Proximal Junctional Kyphosis: A Pediatric and Adult Spinal Deformity Surgery Dilemma","volume":"7","author":"Mika","year":"2019","journal-title":"JBJS Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"408","DOI":"10.5435\/JAAOS-D-14-00143","article-title":"Proximal Junctional Kyphosis Following Spinal Deformity Surgery in the Pediatric Patient","volume":"23","author":"Cho","year":"2015","journal-title":"J. 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