Prevention of proximal junctional kyphosis or failure: Cement augmentation

Vertebral cement augmentation (vertebroplasty) has recently garnered increasing attention as a possible prophylactic treatment for the prevention of proximal junctional kyphosis and proximal junctional failure in osteoporotic patients undergoing long spinal fusions. The supporting data mostly comes from small retrospective case series, but indicates a modest benefit, particularly in the prevention of proximal junctional failure. Common risks include possible cement extravasation leading to embolization events, and a theoretical increased risk of adjacent segment fracture. Deformity surgeons should familiarize themselves with the pros and cons of this technique and may wish to utilize it in appropriately selected cases.