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Incidence of Proximal Junctional Kyphosis (PJK) in Long Posterior Spinal Fusion: A Study Comparing Traditional Open Surgery to Minimally Invasive Percutaneous Technique at the Proximal Fusion Levels

Incidence of Proximal Junctional Kyphosis (PJK) in Long Posterior Spinal Fusion: A Prospective Controlled Randomized Study Comparing Traditional Open Surgery to Minimally Invasive Percutaneous Technique at the Proximal Fusion Levels/Levels

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00890227
Enrollment
48
Registered
2009-04-29
Start date
2009-06-30
Completion date
2017-07-31
Last updated
2018-12-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Kyphosis, Scoliosis

Keywords

scoliosis, kyphosis, Surgical treatment

Brief summary

This research is being done to compare two methods of surgery to treat scoliosis and/or kyphosis of the spine.

Detailed description

Currently, there are two different surgical methods used in the treatment of these problems. One method includes an all open posterior spinal fusion (large incision with opening of the muscles); this is also known as a traditional technique. The second method involves an open surgery for the portion of the spine requiring a fusion except the very top area, where minimally invasive technique (smaller incision and without opening of the muscles) is used. One possible side effect of either method for surgical repair is a condition called proximal junctional kyphosis (PJK). PJK occurs in the form of fracture at the top vertebra involved in the surgery or as a loss of correction of spinal alignment achieved, through gradual bending forward of the spine over time. In this study we want to compare the rate of PJK between two groups of patients undergoing long posterior spinal instrumentation fusion. People undergoing long posterior spinal instrumented fusion may join. About 68 people will join.

Interventions

All level open instrumented posterior spinal fusions

PROCEDUREMinimally invasive technique

Open surgery for all the levels except the proximal segment (most proximal instrumented level) where minimally invasive technique will be used.

Sponsors

Johns Hopkins University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Individuals presenting for surgical correction of scoliosis and/or kyphosis of the thoracolumbar spine are the primary target for enrollment. * Men and women ages 18 years or older will be eligible for participation in the current study. * In addition, individuals must be able to provide informed consent (Mini-Mental State Examination score of at least 18/30).

Design outcomes

Primary

MeasureTime frameDescription
To estimate the rate of proximal junctional fracture or instrumentation failure leading to kyphosis and loss of correction between two groups.12 monthsrate of proximal junctional fracture or instrumentation failure

Secondary

MeasureTime frameDescription
To compare the total operative time between the two groups of surgical patients (as stratified above).12 monthsoperative time
To compare the length of hospital stay between the two groups of surgical patients (as stratified above).12 monthslength of hospital stay
To evaluate complication rate between the two groups.3 monthsrate of complications
To assess change in self-reported pain following surgery between two groups of surgical patients (as stratified above).12 monthspain rating
To assess change in self-reported functional limitations following surgery between two groups of surgical patients (as stratified above).12 monthsoswestry disability index
To compare the total recovery time between the two groups of surgical patients (as stratified above).12 monthstotal recovery time

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026