Selection Of The Optimal Level Of Distal Fixation For Correction Of XXXX 's Hyperkyphosis.

@entity1 @entity8322 @entity1513 @entity1514 @entity85
OBJECTIVE: To analyze the efficacy of the method for selecting the distal level of fusion in treatment of @entity1514 in @entity1 with @entity8322 . BACKGROUND: The fusion area needs to include all the @entity85 in @entity8322 @entity1 ; however, precise levels of the distal fixation have not been determined yet. STUDY DESIGN: Retrospective cohort review. MATERIALS AND METHODS: Thirty-six @entity1 were operated in the Department of @entity1 and Adolescent Spine Pathology between 2007 and 2010. These @entity1 were divided into two groups: in group I (n = 29) a lower instrumented vertebra corresponded to the sagittal stable one and in group II (n = 7) - this vertebra located proximally. RESULTS: The mean preoperative kyphosis was 79.3      11.6  , the postoperative - 40.6      11.9   (correction of 49.9%), loss of correction was 4.9      7.0  . Sagittal balance changed from -0.3    3.2 cm before surgery to -1.7    2.1 cm after surgery. Distal junctional kyphosis developed in 1 case (4%) in Group I, and in 5 cases (71%) in Group II. CONCLUSION: A distal level of instrumentation ending at the first lordotic vertebra is not justified and causes violation of sagittal balance and development of @entity1513 . The inclusion of a sagittal stable vertebra in fusion prevents the development of this undesirable situation.
