A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction: clinical article.

Ames, Christopher P; Smith, Justin S; Scheer, Justin K; Shaffrey, Christopher I; Lafage, Virginie; Deviren, Vedat; Moal, Bertrand; Protopsaltis, Themistocles; Mummaneni, Praveen V; Mundis, Gregory M; Hostin, Richard; Klineberg, Eric; Burton, Douglas C; Hart, Robert; Bess, Shay; Schwab, Frank J; International Spine Study Group

A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction: clinical article.

dc.contributor.author	Ames, Christopher P
dc.contributor.author	Smith, Justin S
dc.contributor.author	Scheer, Justin K
dc.contributor.author	Shaffrey, Christopher I
dc.contributor.author	Lafage, Virginie
dc.contributor.author	Deviren, Vedat
dc.contributor.author	Moal, Bertrand
dc.contributor.author	Protopsaltis, Themistocles
dc.contributor.author	Mummaneni, Praveen V
dc.contributor.author	Mundis, Gregory M
dc.contributor.author	Hostin, Richard
dc.contributor.author	Klineberg, Eric
dc.contributor.author	Burton, Douglas C
dc.contributor.author	Hart, Robert
dc.contributor.author	Bess, Shay
dc.contributor.author	Schwab, Frank J
dc.contributor.author	International Spine Study Group
dc.date.accessioned	2023-08-29T23:39:36Z
dc.date.available	2023-08-29T23:39:36Z
dc.date.issued	2013-09
dc.date.updated	2023-08-29T23:39:30Z
dc.description.abstract	Object Cervical spine osteotomies are powerful techniques to correct rigid cervical spine deformity. Many variations exist, however, and there is no current standardized system with which to describe and classify cervical osteotomies. This complicates the ability to compare outcomes across procedures and studies. The authors' objective was to establish a universal nomenclature for cervical spine osteotomies to provide a common language among spine surgeons. Methods A proposed nomenclature with 7 anatomical grades of increasing extent of bone/soft tissue resection and destabilization was designed. The highest grade of resection is termed the major osteotomy, and an approach modifier is used to denote the surgical approach(es), including anterior (A), posterior (P), anterior-posterior (AP), posterior-anterior (PA), anterior-posterior-anterior (APA), and posterior-anterior-posterior (PAP). For cases in which multiple grades of osteotomies were performed, the highest grade is termed the major osteotomy, and lower-grade osteotomies are termed minor osteotomies. The nomenclature was evaluated by 11 reviewers through 25 different radiographic clinical cases. The review was performed twice, separated by a minimum 1-week interval. Reliability was assessed using Fleiss kappa coefficients. Results The average intrarater reliability was classified as "almost perfect agreement" for the major osteotomy (0.89 [range 0.60-1.00]) and approach modifier (0.99 [0.95-1.00]); it was classified as "moderate agreement" for the minor osteotomy (0.73 [range 0.41-1.00]). The average interrater reliability for the 2 readings was the following: major osteotomy, 0.87 ("almost perfect agreement"); approach modifier, 0.99 ("almost perfect agreement"); and minor osteotomy, 0.55 ("moderate agreement"). Analysis of only major osteotomy plus approach modifier yielded a classification that was "almost perfect" with an average intrarater reliability of 0.90 (0.63-1.00) and an interrater reliability of 0.88 and 0.86 for the two reviews. Conclusions The proposed cervical spine osteotomy nomenclature provides the surgeon with a simple, standard description of the various cervical osteotomies. The reliability analysis demonstrated that this system is consistent and directly applicable. Future work will evaluate the relationship between this system and health-related quality of life metrics.
dc.identifier.issn	1547-5654
dc.identifier.issn	1547-5646
dc.identifier.uri	https://hdl.handle.net/10161/28826
dc.language	eng
dc.publisher	Journal of Neurosurgery Publishing Group (JNSPG)
dc.relation.ispartof	Journal of neurosurgery. Spine
dc.relation.isversionof	10.3171/2013.5.spine121067
dc.subject	International Spine Study Group
dc.subject	Cervical Vertebrae
dc.subject	Humans
dc.subject	Spinal Curvatures
dc.subject	Osteotomy
dc.subject	Consensus
dc.subject	Terminology as Topic
dc.title	A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction: clinical article.
dc.type	Journal article
duke.contributor.orcid	Shaffrey, Christopher I\|0000-0001-9760-8386
pubs.begin-page	269
pubs.end-page	278
pubs.issue	3
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Orthopaedic Surgery
pubs.organisational-group	Neurosurgery
pubs.publication-status	Published
pubs.volume	19