An Effective and Safe Surgical Technique for Salvage of Postoperative Proximal Junctional Failure in Pediatric Patients—A Case Series

Background: Proximal junctional failure (PJF) is a known complication following posterior spinal fusion surgery and can be defined simply as proximal kyphosis that requires surgical revision of the instrumentation. PJF associated with pain, decreased neurologic function, infection, increased morbidity. There little literature on this topic in children especially specific techniques for surgery. Methods: The technique involves extending spine instrumentation proximally paired sets sublaminar bands used anchors. Posterior osteotomies are typically required at level kyphosis. gradually sequentially tightened, bringing into corrected sagittal position. Patients who underwent procedure had least 1 year follow-up were identified. Demographic clinical data, well plain radiographic CT parameters, analyzed before most recent follow-up. Results: Eight children, average age 14 years, 10 months, included study an time 31 months. Revision occurred approximately 3 years initial was 20 degrees (ranging from increase 18° to decrease 46 degrees) mean kyphotic angle correction site 16 24 78 cervical lordosis correction, using 6 bands. Before revision, all patients reported neck/upper back upper rod prominence. At post-revision visit, pain markedly reduced, prominence resolved. One patient satisfaction appearance, another noted maintaining horizontal gaze easier. Conclusion: Children received their experienced resolution improved parameters maintained after