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Study Design.

Retrospective cohort.

Objective.

To explore proximal junctional kyphosis (PJK) as a function of age-adjusted surgical correction goals.

Summary of Background Data.

Recent adult spinal deformity (ASD) studies show that alignment targets are age-specific. Despite recognizing age and malalignment as PJK risk factors, no study has assessed the age-specific effects of alignment on PJK.

Methods.

ASD patients with fusions to the pelvis were included and stratified into three groups: young adults (YA< 40 years old), middle aged (MA: 40–65 years old), and the elderly (ED> 65 years old). Analysis of variance compared the groups with respect to 1-year postoperative alignments and 1-year offsets from age-specific alignment targets.

Results.

A total of 679 patients were enrolled (mean age= 61 years old, 77% female, body mass index= 28.1). At 1 year postoperatively, there was a significant decrease in pelvic tilt …