A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years.

dc.contributor.author

Jalai, Cyrus M

dc.contributor.author

Passias, Peter G

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Lafage, Virginie

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Smith, Justin S

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Lafage, Renaud

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Poorman, Gregory W

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Diebo, Bassel

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Liabaud, Barthélemy

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Neuman, Brian J

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Scheer, Justin K

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Shaffrey, Christopher I

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Bess, Shay

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Schwab, Frank

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Ames, Christopher P

dc.contributor.author

International Spine Study Group (ISSG)

dc.date.accessioned

2023-07-09T22:21:20Z

dc.date.available

2023-07-09T22:21:20Z

dc.date.issued

2016-08

dc.date.updated

2023-07-09T22:21:19Z

dc.description.abstract

Purpose

Characteristics specific to cervical deformity (CD) concomitant with adult thoracolumbar deformity (TLD) remains uncertain, particularly regarding treatment. This study identifies cervical malalignment prevalence following surgical and conservative TLD treatment through 2 years.

Methods

Retrospective analysis of a prospective, multicenter adult spinal deformity (ASD) database. CD was defined in operative and non-operative ASD patients according to the following criteria: T1 Slope minus Cervical Lordosis (T1S-CL) ≥20°, C2-C7 Cervical Sagittal Vertical Axis (cSVA) ≥40 mm, C2-C7 kyphosis >10°. Differences in rates, demographics, health-related quality of life (HRQoL) scores for Oswestry Disability Index (ODI) and Scoliosis Research Society Questionnaire (SRS-22r), and radiographic variables were assessed between treatment groups (Op vs. Non-Op) and follow-up periods (baseline, 1-year, 2-year).

Results

Three hundred and nineteen (200 Op, 199 Non-Op) ASD patients were analyzed. Op patients' CD rates at 1 and 2 years were 78.9, and 63.0 %, respectively. Non-Op CD rates were 21.1 and 37.0 % at 1 and 2 years, respectively. T1S-CL mismatch and cSVA malalignment characterized Op CD at 1 and 2 years (p < 0.05). Op and Non-Op CD groups had similar cervical/global alignment at 1 year (p > 0.05 for all), but at 2 years, Op CD patients had worse thoracic kyphosis (TK), T1S-CL, CL, cSVA, C2-T3 SVA, and global SVA compared to Non-Ops (p < 0.05). Op CD patients had worse ODI, and SRS Activity at 1 and 2 years post-operative (p < 0.05), but had greater 2-year SRS Satisfaction scores (p = 0.019).

Conclusions

In the first study to compare cervical malalignment at extended follow-up between ASD treatments, CD rates rose overall through 2 years. TLD surgery, resulting in higher CD rates characterized by T1S-CL and cSVA malalignment, produced poorer HRQoL. This information can aid in treatment method decision-making when cervical deformity is present concomitant with TLD.
dc.identifier

10.1007/s00586-016-4564-7

dc.identifier.issn

0940-6719

dc.identifier.issn

1432-0932

dc.identifier.uri

https://hdl.handle.net/10161/28418

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

dc.relation.isversionof

10.1007/s00586-016-4564-7

dc.subject

International Spine Study Group (ISSG)

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Neck

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Cervical Vertebrae

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Lumbar Vertebrae

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Thoracic Vertebrae

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Humans

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Spinal Diseases

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Kyphosis

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Lordosis

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Scoliosis

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Postoperative Period

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Prevalence

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Retrospective Studies

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Follow-Up Studies

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Quality of Life

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Databases, Factual

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Adult

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Aged

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Middle Aged

dc.subject

Patient Satisfaction

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Female

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Male

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Surveys and Questionnaires

dc.title

A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

2423

pubs.end-page

2432

pubs.issue

8

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

25

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