The Hsu-lace: A novel technique to prevent PJF.

OBJECTIVE

This retrospective study assesses the efficacy of Hsu-lace technique in creating a “soft landing” for patients submitted to thoraco-lumbar-pelvic reconstruction intending to reduce proximal junction failure and reoperation rates. The present study aims to show a new technique in Adult Spine Deformity (ASD) surgery looking into the effects of the artificial interspinous Nylon and Tendon soft stabilization on proximal junction kyphosis/failure (PJK/PJF) and extension of fusion rates.

METHODS

A retrospective review was conducted on 53 patients who underwent thoraco-lumbar-pelvis fusion for ASD since 2019. Patients were categorized in two groups based on artificial interspinous stabilization in which the use was determined based on the instrumentation chose in each case – Nile-Life Health Care (LHC)(n = 27) or Tendon/Ausbio-APM(n = 26). Data collection included demographics, surgical details, follow-up, PJK, time of PJK, reoperation, and extension of fusion.

RESULTS

8 patients developed PJK before 6 months and 5 were submitted to extension of fusion. 80% of these patients extended were from the Nile-LHC group. Despite this, we had 3 patients that developed PJK but had no proximal junction failure (PJF).

CONCLUSION

We believe the Hsu-lace technique is valid and changed our practice reducing our PJF and extension of fusion rates.