Biomechanical Analysis of Acute Proximal Junctional Failure After Surgical Instrumentation of Adult Spinal Deformity: The Impact of Proximal Implant Type, Osteotomy Procedures, and Lumbar Lordosis Restoration*

Using hooks at UIV and reducing posterior proximal spinal element dissection lowered stress levels in the proximal junctional spinal segment and thus reduced the biomechanical risks of PJF. LL restoration was associated with increased stress levels in postoperative functional upper body flexion.