Cervical Spine Deformity Correction Techniques

Dru, Alexander; Lockney, Dennis T.; Vaziri, Sasha; Decker, Matthew; Polifka, Adam; Fox, W. Christopher; Hoh, Daniel J.

doi:10.14245/ns.1938288.144

Cited by 40 publications

(43 citation statements)

References 41 publications

(41 reference statements)

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“…17,25 Surgical approaches of the deformity correction include anterior, posterior, or combined anterior and posterior (360°) approach. 26 Not a few factors are considered to determine which of the approach is needed, including the location of compressive pathology, type, flexibility and location of the deformity. 27,28 There has been no clear goal of CL to be achieved in cervical deformity correction surgery.…”

Section: Surgical Impact On Gsa Following Cervical Kyphosis Correctiomentioning

confidence: 99%

Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review

2020

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When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. These compensations occur through mobile spine segments as well as pelvic tilt and lower extremities. The purpose of this review was to understand the surgical impact on global sagittal alignment and health-related quality of life (HRQoL) following cervical kyphosis correction surgery. The cervical kyphosis correction surgery induces reciprocal changes in craniocervical and thoracolumbar alignment. Successful cervical deformity correction needs to focus not only on restoring proper cervical lordosis, but also on achieving global balance of the cervical spine with other parts of the spine. The goal of the surgery is to achieve occiputtrunk (OT) concordance (the center of gravity-C7 sagittal vertical axis < 30 mm) and cervical sagittal balance. Once OT-concordance is achieved, subsequent thoracolumbar alignment changes occur as needed to harmonize global spinal alignment. Reciprocal changes after surgery exhibit different patterns depending on whether patients have compensation ability in their thoracolumbar spine or not. C2-7 sagittal vertical axis and sagittal morphotype of the cervical kyphosis are correlated with HRQoL. Changes in cervical lordosis minus T1 slope correlate to HRQoL improvements.

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Section: Surgical Impact On Gsa Following Cervical Kyphosis Correctiomentioning

confidence: 99%

Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review

2020

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“…Cervical kyphotic deformity can be quite debilitating. Most patients present with neck pain, but they can also present with radiculopathy, myelopathy, altered vertical gaze, swallowing problems, and even cosmetic issues from severe kyphotic deformity [1]. The presence of normal cervical lordosis can be attributed to the relatively increased disc height anteriorly compared to posteriorly.…”

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confidence: 99%

Kyphosis Correction in Patients Undergoing a Four-Level Anterior Cervical Discectomy and Fusion

Ebot

Foskey

Domingo

et al. 2020

Cureus

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Introduction Cervical kyphotic deformity can be quite debilitating. Most patients present with neck pain, but they can also present with radiculopathy, myelopathy, altered vertical gaze, swallowing problems, and even cosmetic issues from the severe kyphotic deformity. After failing conservative management, surgery remains the only option for halting symptom progression. Surgical options for cervical kyphosis have included anterior-only approaches, posterior-only approaches, or 360-and 540-degree reconstructions. This paper addresses the correction of cervical kyphotic deformity via an anterior-only approach consisting of a four-level anterior cervical discectomy and fusion (ACDF). Methods We interrogated our procedure log system and the keyword "anterior cervical discectomy and fusion (ACDF)" was typed into the search bar. All patients with an ACDF for the past five years were reviewed and patients with a four-level ACDF were selected. Chart review was performed and patients presenting with multi-level cervical stenosis with kyphosis were included in the study. Pre-and post-surgery images were reviewed, and the degrees of pre-operative kyphosis and post-operative lordosis were measured. Results Our search produced 20 patients. All the patients had a diagnosis of multi-level cervical stenosis with or without myelopathy and were all symptomatic. Pre-operative kyphosis ranged from 2.3 to 35 (mean 11.5) degrees, and post-operative lordosis ranged from 2 to 38 (mean 16) degrees. All the patients had varying degrees of kyphosis correction post-surgery which ranged from 6 to 44 (mean 27) degrees. Significant improvement or complete resolution of symptoms post-operatively occurred in all patients. Conclusion Four-level ACDF in carefully selected patients can be used to correct cervical alignment in patients presenting with symptomatic multi-level cervical stenosis with kyphosis.

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“…However, CSD surgery has a variety of approaches (anterior approach, posterior approach, simultaneous anteriorposterior approach, and 540° approach) because of the surrounding neurovascular structures, so expressing surgical grade of CSD surgery could be rather complicated. 15,19,20,[22][23][24]30 Recently, a classification system has been developed to standardize the description of cervical osteotomy types. 3 This system is a 7-point scale based on anatomical resections that are graded according to the potential for destabilization.…”

Section: Discussionmentioning

confidence: 99%

SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity

Hong

Koller

Abumi³

et al. 2020

Neurospine

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Although cervical spinal deformity (CSD) can have a profoundly negative impact on an individual's quality of life and there have been many advances in surgical treatment of CSD in recent years, there exists no comprehensive classification system of surgical treatment that categorizes anterior and posterior surgery separately according to the grade of surgery. The objective of this study is to introduce the new classification system of various surgical treatments for CSD. We developed a new classification system (SOF system) for CSD surgery that describes the sequence of surgical approach (S), the grade of osteotomy (O), and the information of fixation (F) using alphanumeric codes. This new classification system can provide a consistent description of the various osteotomies performed in CSD surgery. Especially, regarding research, there has been a clear benefit to this classification. Having a standardized classification that allows for common frame for cervical deformity correction surgery, communication between surgeons and the evaluation of the CSD surgeries make it possible to conduct global comparative research about surgical outcome.

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Cervical Spine Deformity Correction Techniques

Cited by 40 publications

References 41 publications

Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review

Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review

Kyphosis Correction in Patients Undergoing a Four-Level Anterior Cervical Discectomy and Fusion

SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity

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