Cervical sagittal alignment in patients with dropped head syndrome

Qian, Weiqing; Endo, Kenji; Aihara, Takato; Sawaji, Yasunobu; Suzuki, Hidekazu; Matsuoka, Yuji; Takamatsu, Taichiro; Murata, Kazuma; Yamamoto, Kenjiro

doi:10.1177/2309499021990112

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…Multiple disorders of the cervical spine can lead to an imbalance in the sagittal alignment of the cervical spine 32,33 , and the linkage and interplay between cervical sagittal alignment parameters was demonstrated in this study. In both ACDF and HS, reconstruction of the CL is performed, making both cervical lordosis and T1S more pronounced.…”

Section: Discussionsupporting

confidence: 51%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Chen

Deng

Líu

et al. 2022

Preprint

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Introduction: According to the different numbers and relative locations of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of this retrospective study was to compare the sagittal alignment parameters of HS and ACDF for cervical degenerative disc disease (CDDD) and the association of the respective parameters. Methods: This study involved patients with three-level CDDD who underwent ACDF or HS at our institution between June 2012 and August 2021. This follow-up included one-level CDR and two-level ACDF (type I group), two-level CDR and one-level ACDF (type II group) and three-level ACDF. Cervical sagittal alignment parameters included cervical lordosis (CL), segment alignment (SA), T1 slope (T1S), C2-C7 sagittal vertical axis (SVA), T1S-CL, C2 slope (C2S), occipital to C2 angle (O-C2A) and segment range of motion (ROM).Postoperative complications included adjacent segment degeneration (ASD), imbalance, prosthetic subsidence and heterotopic ossification (HO). Results: The three groups with a total of 106 patients were better matched in terms of demographics. Patients who underwent HS had significantly higher CL than those who underwent ACDF at 1 week, 6 months, 12 months and the final follow-up after surgery, as well as significantly better SA at 12 months and the final follow-up. There was no significant difference in T1S, SVA, T1S-CL, C2S, O-C2A or segment ROM among the three groups after surgery. The T1S-CL was significantly associated with C2S in the type I and type II groups at the preoperative and final follow-up. There was no significant difference in postoperative complications among the three groups. Conclusions: Most improvements in cervical sagittal alignment (CL, SA, T1S, SVA, T1S-CL, C2S, O-C2A, and segmental ROM) were observed in all three groups postoperatively. HS was more advantageous than ACDF in the maintenance of postoperative CL and SA. Thus, three-level HS may be better for maintaining cervical curvature. The number of replacement segments differed in those who underwent HS but did not affect the correlation between T1S-CL and C2S, both of which are well balanced.

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Section: Discussionsupporting

confidence: 51%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Chen

Deng

Líu

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Multiple disorders of the cervical spine can lead to an imbalance in the sagittal alignment of the cervical spine [ 27 , 28 ], and the linkage and interplay between cervical sagittal alignment parameters was demonstrated in this study. In both ACDF and HS, reconstruction of the CL is performed, making both cervical lordosis and T1S more pronounced.…”

Section: Discussionmentioning

confidence: 71%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

et al. 2023

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Introduction According to the different numbers and relative locations of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of this retrospective study was to compare the sagittal alignment parameters of HS and ACDF for cervical degenerative disc disease (CDDD) and the association of the respective parameters. Methods This study involved patients with three-level CDDD who underwent ACDF or HS at our institution between June 2012 and August 2021. This follow-up included one-level CDR and two-level ACDF (type I group), two-level CDR and one-level ACDF (type II group) and three-level ACDF. Cervical sagittal alignment parameters included cervical lordosis (CL), segment alignment (SA), T1 slope (T1S), C2–C7 sagittal vertical axis (SVA), T1S-CL, C2 slope (C2S), occipital to C2 angle (O-C2A) and segment range of motion (ROM). Postoperative complications included adjacent segment degeneration, imbalance, prosthetic subsidence and heterotopic ossification. Results The three groups with a total of 106 patients were better matched in terms of demographics. Patients who underwent HS had significantly higher CL than those who underwent ACDF at 1 week, 6 months, 12 months and the final follow-up after surgery, as well as significantly better SA at 12 months and the final follow-up. There was no significant difference in T1S, SVA, T1S-CL, C2S, O-C2A or segment ROM among the three groups after surgery. The T1S-CL was significantly associated with C2S in the type I and type II groups at the preoperative and final follow-up. There was no significant difference in postoperative complications among the three groups. Conclusions Most improvements in cervical sagittal alignment (CL, SA, T1S, SVA, T1S-CL, C2S, O-C2A, and segmental ROM) were observed in all three groups postoperatively. HS was more advantageous than ACDF in the maintenance of postoperative CL and SA. Thus, three-level HS may be better for maintaining cervical curvature. The number of replacement segments differed in those who underwent HS but did not affect the correlation between T1S-CL and C2S, both of which are well balanced.

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“…A typical example of chin-on-chest deformity is the dropped head syndrome (DHS) [ 8 , 30 , 31 ]. This type of severe kyphotic deformity results from the decreased strength of extensor muscles due to different, mostly neuromuscular diseases, such as amyotrophic lateral sclerosis (ALS), Parkinson’s disease, polymyositis, myasthenia gravis, genetic myopathies, motor neuron disease, or post-radiation atrophy [ 8 , 30 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Progressive Pediatric Post-Traumatic Kyphotic Deformity

et al. 2023

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Cervical kyphosis is a rare entity with challenging management due to the limitations of pediatric age, along with a growing spine. The pathogenesis is made up of a large group of congenital, syndromic and acquired deformities after posterior element deterioration or as a result of previous trauma or surgery. In rare progressive cases, kyphotic deformities may result in severe “chin-on-chest” deformities with severe limitations. The pathogenesis of progression to severe kyphotic deformity after minor hyperflexion trauma is not clear without an obvious MR pathology; it is most likely multifactorial. The authors present the case of a six-month progression of a pediatric cervical kyphotic deformity caused by a cervical spine hyperflexion injury, and an MR evaluation without the pathology of disc or major ligaments. Surgical therapy with a posterior fixation and fusion, together with the preservation of the anterior growing zones of the cervical spine, are potentially beneficial strategies to achieve an excellent curve correction and an optimal long-term clinical outcome in this age group.

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Cervical sagittal alignment in patients with dropped head syndrome

Cited by 5 publications

References 21 publications

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Acute Progressive Pediatric Post-Traumatic Kyphotic Deformity

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