Scholarlink

Purpose <p>To report a complex case of proximal junctional failure (PJF) associated with acute thoracic disc herniation (TDH) in the mid-thoracic spine following thoracolumbar fusion.</p> Methods <p>Case report.</p> Results <p>A 74-year-old female with osteoporosis and rheumatoid arthritis underwent multiple spinal fusion and revision surgeries, culminating in a T9–S1 fusion. Two months following the third revision, she developed PJF. Seven months following the third revision, she presented with severe pain and progressive sensory loss in both lower extremities (predominantly left side). Neurological examination revealed incomplete paraparesis (AIS grade C). While initial cervical MRI findings were unremarkable, thoracic imaging demonstrated a T8 vertebral fracture and a significant T8/9 disc herniation causing spinal stenosis. The patient underwent T5–S1 revision surgery, including T8 laminectomy and sequestrectomy. Seven months after the fourth revision surgery, her neurological function improved significantly to AIS grade E, with significant pain relief.</p> Conclusion <p>PJF may precipitate acute intervertebral disc herniation due to excessive biomechanical stress at the adjacent mobile segment. Early restoration of sagittal alignment and proactive spinal stabilization are crucial for protecting spinal cord function.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Proximal junctional failure combined with symptomatic thoracic disc herniation: a rare case report

  • 期刊论文

  • 发表日期：

    2026年6月15日

查看全文
  • Xuejun Zhang,
  • Lukas Klein,
  • Nils Mühlenfeld,
  • Oliver Huwert,
  • Frank Hassel

摘要

Purpose

To report a complex case of proximal junctional failure (PJF) associated with acute thoracic disc herniation (TDH) in the mid-thoracic spine following thoracolumbar fusion.

Methods

Case report.

Results

A 74-year-old female with osteoporosis and rheumatoid arthritis underwent multiple spinal fusion and revision surgeries, culminating in a T9–S1 fusion. Two months following the third revision, she developed PJF. Seven months following the third revision, she presented with severe pain and progressive sensory loss in both lower extremities (predominantly left side). Neurological examination revealed incomplete paraparesis (AIS grade C). While initial cervical MRI findings were unremarkable, thoracic imaging demonstrated a T8 vertebral fracture and a significant T8/9 disc herniation causing spinal stenosis. The patient underwent T5–S1 revision surgery, including T8 laminectomy and sequestrectomy. Seven months after the fourth revision surgery, her neurological function improved significantly to AIS grade E, with significant pain relief.

Conclusion

PJF may precipitate acute intervertebral disc herniation due to excessive biomechanical stress at the adjacent mobile segment. Early restoration of sagittal alignment and proactive spinal stabilization are crucial for protecting spinal cord function.