{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:18:15Z","timestamp":1787847495612,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"\n Background:<\/jats:title>\n Age-adjusted alignment targets in the context of distal junctional kyphosis (DJK) development have yet to be investigated. Our aim was to assess age-adjusted alignment targets, reciprocal changes, and role of lowest instrumented level orientation in DJK development in cervical deformity (CD) patients.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n CD patients were evaluated based on lowest fused level: cervical (C7 or above), upper thoracic (UT: T1\u2013T6), and lower thoracic (LT: T7\u2013T12). Age-adjusted alignment targets were calculated using published formulas for sagittal vertical axis (SVA), pelvic incidence-lumbar lordosis (PI-LL), pelvic tilt (PT), T1 pelvic angle (TPA), and LL-thoracic kyphosis (TK). Outcome measures were cervical and global alignment parameters: Cervical SVA (cSVA), cervical lordosis, C2 slope, C2\u2013T3 angle, C2\u2013T3 SVA, TS-CL, PI-LL, PT, and SVA. Subanalysis matched baseline PI to assess age-adjusted alignment between DJK and non-DJK.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Seventy-six CD patients included. By 1Y, 20 patients developed DJK. Non-DJK patients had 27% cervical lowest instrumented vertebra (LIV), 68% UT, and 5% LT. DJK patients had 25% cervical, 50% UT, and 25% LT. There were no baseline or 1Y differences for PI, PI-LL, SVA, TPA, or PT for actual and age-adjusted targets. DJK patients had worse baseline cSVA and more severe 1Y cSVA, C2\u2013T3 SVA, and C2 slope (\n P<\/jats:italic>\n < 0.05). The distribution of over\/under corrected patients and the offset between actual and ideal alignment for SVA, PT, TPA, PI-LL, and LL-TK were similar between DJK and non-DJK patients. DJK patients requiring reoperation had worse postoperative changes in all cervical parameters and trended toward larger offsets for global parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n CD patients with severe baseline malalignment went on to develop postoperative DJK. Age-adjusted alignment targets did not capture differences in these populations, suggesting the need for cervical-specific goals.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_170_20","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T09:28:56Z","timestamp":1614763736000},"page":"65-71","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Effect of age-adjusted alignment goals and distal inclination angle on the fate of distal junctional kyphosis in cervical deformity surgery"],"prefix":"10.4103","volume":"12","author":[{"given":"Peter Gust","family":"Passias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha 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Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.JCVJS_170_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:20:02Z","timestamp":1787844002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.JCVJS_170_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_170_20","relation":{},"ISSN":["0974-8237"],"issn-type":[{"value":"0974-8237","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}