Sagittal Balance Parameters and Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis: Dataset and Results.

To review and evaluate multiple preoperative and postoperative sagittal parameters and their association with the risk of developing proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS) who undergo correction surgery. We performed a systematic search in December 2022 in PubMed, Embase and the Cochrane Library to retrieve all the studies relevant to our research. After the study selection and data extraction following PRISMA guidelines, RevMan 5.3 was used for statistical analysis. All the analyzed factors were evaluated by using odds ratios and weighted mean differences with 95% confidence intervals. Moreover, the meta-analysis of proportions via MedCalc was used for analyzing quantitative data from the studies. 22 studies were included in our meta-analysis. All the available values of sagittal parameters were evaluated. Among all the potential risk factors, higher preoperative thoracic kyphosis (Test for overall effect Z = 11.79, p &lt; 0.00001), higher preoperative sagittal vertical axis (SVA) (test for overall effect Z = 11.19, p &lt; 0.00001), greater thoracic kyphosis change post-op. compared to pre-op. (test for overall effect Z = 6.02, p &lt; 0.00001), increased postoperative lumbar lordosis (test for overall effect Z = 3.65, p = 0.0003), higher post-op. SVA (test for overall effect Z = 24.93, p &lt; 0.00001) and a larger pelvic incidence/lumbar lordosis (PI/LL) mismatch (test for overall effect Z = 20.50, p &lt; 0.00001) were found to be the risk factors for PJK after AIS surgery. Moreover, a decreased rod contour angle (RCA) (test for overall effect Z = 3.79, p &lt; 0.0002) and higher proximal junctional angle–rod contour angle (PJA-RCA) (test for overall effect Z = 39.18, p &lt; 0.00001) play a significant role in the risk of developing PJK after AIS correction.本研究旨在回顾并评估接受矫形手术的青少年特发性脊柱侧凸（adolescent idiopathic scoliosis, AIS）患者术前、术后的多项矢状面参数，以及这些参数与近端交界性后凸（proximal junctional kyphosis, PJK）发病风险的关联。我们于2022年12月在PubMed、Embase及Cochrane图书馆开展系统检索，以获取与本研究主题相关的全部文献。按照优先报告条目系统综述和Meta分析指南（PRISMA guidelines）完成文献筛选与数据提取后，采用RevMan 5.3软件进行统计学分析。所有分析因素均通过比值比（odds ratios）与加权均数差（weighted mean differences）结合95%置信区间（95% confidence intervals）进行评估。此外，本研究借助MedCalc软件开展比例Meta分析，以处理纳入研究的定量数据。本研究共纳入22项相关研究，并对所有可获取的矢状面参数值进行了评估。在所有潜在危险因素中，术前较高的胸椎后凸（整体效应检验Z=11.79，P<0.00001）、术前较高的矢状面垂直轴（sagittal vertical axis, SVA）（整体效应检验Z=11.19，P<0.00001）、术后较术前更大的胸椎后凸变化量（整体效应检验Z=6.02，P<0.00001）、术后更高的腰椎前凸（整体效应检验Z=3.65，P=0.0003）、术后较高的SVA（整体效应检验Z=24.93，P<0.00001）以及更大的骨盆入射角/腰椎前凸（pelvic incidence/lumbar lordosis, PI/LL）匹配失衡（整体效应检验Z=20.50，P<0.00001），均被证实为AIS术后PJK的危险因素。此外，棒轮廓角（rod contour angle, RCA）降低（整体效应检验Z=3.79，P<0.0002）以及近端交界角-棒轮廓角（proximal junctional angle–rod contour angle, PJA-RCA）升高（整体效应检验Z=39.18，P<0.00001），同样对AIS矫形术后PJK的发病风险存在显著影响。