Neurospine (Sep 2021)
Prioritization of Realignment Associated With Superior Clinical Outcomes for Cervical Deformity Patients
- Katherine E. Pierce,
- Peter G. Passias,
- Avery E. Brown,
- Cole A. Bortz,
- Haddy Alas,
- Lara Passfall,
- Oscar Krol,
- Nicholas Kummer,
- Renaud Lafage,
- Dean Chou,
- Douglas C. Burton,
- Breton Line,
- Eric Klineberg,
- Robert Hart,
- Jeffrey Gum,
- Alan Daniels,
- Kojo Hamilton,
- Shay Bess,
- Themistocles Protopsaltis,
- Christopher Shaffrey,
- Frank A. Schwab,
- Justin S. Smith,
- Virginie Lafage,
- Christopher Ames,
Affiliations
- Katherine E. Pierce
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Peter G. Passias
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Avery E. Brown
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Cole A. Bortz
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Haddy Alas
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Lara Passfall
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Oscar Krol
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Nicholas Kummer
- Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY, USA
- Renaud Lafage
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
- Dean Chou
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Douglas C. Burton
- Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA
- Breton Line
- Rocky Mountain Scoliosis and Spine, Denver, CO, USA
- Eric Klineberg
- Department of Orthopaedic Surgery, University of California, Davis, Davis, CA, USA
- Robert Hart
- Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Seattle, WA, USA
- Jeffrey Gum
- Norton Leatherman Spine Center, Louisville, KY, USA
- Alan Daniels
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Kojo Hamilton
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Shay Bess
- Department of Spine Surgery, Denver International Spine Clinic, Presbyterian St. Luke’s/Rocky Mountain Hospital for Children, Denver, CO, USA
- Themistocles Protopsaltis
- Department of Orthopaedics, NYU Langone Orthopedic Hospital, New York, NY, USA
- Christopher Shaffrey
- Departments of Neurosurgery and Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
- Frank A. Schwab
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
- Justin S. Smith
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA
- Virginie Lafage
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
- Christopher Ames
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- DOI
- https://doi.org/10.14245/ns.2040540.270
- Journal volume & issue
-
Vol. 18,
no. 3
pp. 506 – 514
Abstract
Objective To prioritize the cervical parameter targets for alignment. Methods Included: cervical deformity (CD) patients (C2–7 Cobb angle > 10°, cervical lordosis > 10°, cervical sagittal vertical axis [cSVA] > 4 cm, or chin-brow vertical angle > 25°) with full baseline (BL) and 1-year (1Y) radiographic parameters and Neck Disability Index (NDI) scores; patients with cervical [C] or cervicothoracic [CT] Primary Driver Ames type. Patients with BL Ames classified as low CD for both parameters of cSVA (0.050). Decision tree analysis determined cutoffs for radiographic change, prioritizing in the following order: ≥ 42.5° C2–T3 angle, > 35.4° cervical lordosis, -30.8-mm C2–T3 SVA, and ≤ -33.6° TS–CL. Conclusion Certain ratios of correction of cervical parameters contribute to improving neck disability. Prioritizing these radiographic alignment parameters may help optimize patient-reported outcomes for patients undergoing CD surgery.
Keywords
