الفهرس 
Acknowledgment
IncidenceOnly 14 pages are availabe for public view
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Abstract
Junctional kyphosis is a common problem that complicates long segment spinal fusions, while failure is a serious problem. The etiology of junctional kyphosis is probably multifactorial. According to this study risk factors include: Preoperative PJA >10°.Roussouly types 1 and 3 AP may have increased risk of PJK Contrary to the literature, fusion to the sacrum may guard against the development of junctional kyphosis Junctional kyphosis results in lower patient related outcome. In the light of current information and absence of single cause for the development of PJK and PJF, we recommend the following measures to avoid Pre-operative measurement of BMD in all patients. Prophylactic vertebroplasty in osteoporotic patients for the UIV and UIV+1. Consider using proximal tether Avoid injury to the SSL, ISL, and facet joints. Contouring of the rod proximally to avoid stresses on the implant. Try to obtain the optimum sagittal balance according to Roussoly types as dictated by the pelvic incidence.