1. Prioritization of realignment associated with superior clinical outcomes for surgical cervical deformity patients
- Author
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Katherine E Pierce, Peter Gust Passias, Avery E Brown, Cole A Bortz, Haddy Alas, Renaud Lafage, Oscar Krol, 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, and International Spine Study Group
- Subjects
cervical deformity ,prioritization ,realignment ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background: To optimize quality of life in patients with cervical deformity (CD), there may be alignment targets to be prioritized. Objective: To prioritize the cervical parameter targets for alignment. Methods: Included: CD patients (C2–C7 Cobb >10°°, C2–C7 lordosis [CL] >10°°, 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 cut-offs for radiographic change, prioritizing in the following order: ≥42.5° C2-T3 angle, >35.4° CL, −30.8 mm C2-T3 SVA, and ≤−33.6° TS-CL. Conclusions: 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.
- Published
- 2021
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