scholarly journals Cervical Spine Deformity—Part 3: Posterior Techniques, Clinical Outcome, and Complications

Neurosurgery ◽  
2017 ◽  
Vol 81 (6) ◽  
pp. 893-898 ◽  
Author(s):  
Lee A Tan ◽  
K Daniel Riew ◽  
Vincent C Traynelis
Keyword(s):  
Cervical Spine ◽  
Postoperative Complications ◽  
Clinical Outcome ◽  
Surgical Outcome ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Spinal Stabilization ◽  
Cervical Deformity ◽  
Surgical Options ◽  
Horizontal Gaze

Abstract The goals of cervical deformity surgery include deformity correction, restoration of horizontal gaze, decompression of neural elements, spinal stabilization with a biomechanically sound construct, and meticulous arthrodesis technique to prevent pseudoarthrosis and minimizing surgical complications. Many different surgical options exist, but selecting the correct approach that ensures the optimal clinical outcome can be challenging and often controversial. In this last part of the cervical deformity review series, various posterior deformity correction techniques are discussed in detail, along with an overview of surgical outcome and postoperative complications.

scholarly journals Cervical Spine Deformity—Part 1: Biomechanics, Radiographic Parameters, and Classification

Neurosurgery ◽  
2017 ◽  
Vol 81 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Lee A. Tan ◽  
K. Daniel Riew ◽  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Clinical Outcome ◽  
Negative Impact ◽  
Surgical Techniques ◽  
Operative Management ◽  
Spine Deformity ◽  
Radiographic Parameters ◽  
Spine Deformities ◽  
Significant Negative Impact ◽  
Surgical Options

Abstract Cervical spine deformities can have a significant negative impact on the quality of life by causing pain, myelopathy, radiculopathy, sensorimotor deficits, as well as inability to maintain horizontal gaze in severe cases. Many different surgical options exist for operative management of cervical spine deformities. However, selecting the correct approach that ensures the optimal clinical outcome can be challenging and is often controversial. We aim to provide an overview of cervical spine deformity in a 3-part series covering topics including the biomechanics, radiographic parameters, classification, treatment algorithms, surgical techniques, clinical outcome, and complication avoidance with a review of pertinent literature.

scholarly journals Cervical Spine Deformity Correction Techniques

Neurospine ◽  
2019 ◽  
Vol 16 (3) ◽  
pp. 470-482 ◽  
Author(s):  
Alexander B. Dru ◽  
Dennis Timothy Lockney ◽  
Sasha Vaziri ◽  
Matthew Decker ◽  
Adam J. Polifka ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Deformity Correction ◽  
Spine Deformity

SEGMENTARNAYa SPINAL'NAYa DISGENEZIYa

2003 ◽  
Vol 10 (1) ◽  
pp. 35-38
Author(s):  
A Yu Mushkin ◽  
E V Ul'rikh ◽  
D V Elyakin
Keyword(s):  
Rare Variant ◽  
Surgical Outcome ◽  
Spinal Canal ◽  
Deformity Correction ◽  
Early Operation ◽  
Spine Deformity ◽  
Severe Stenosis ◽  
Spine Stability ◽  
Examination Technique ◽  
Simultaneous Elimination

Segmental spine dysgeusia is a rare variant of vertebral abnormality that is characterized by severe stenosis of spinal canal, severe spine deformity, spine instability accompanied by congenital isolated spine malformation. Optimum method for the treatment is an early operation directed to simultaneous elimination of spine cord stenosis, deformity correction and restoration of spine stability. The results of examination, technique and surgical outcome are presented for a 2 years and 7 months child with segmental spine dysgeusia.

scholarly journals Relationship between degree of focal kyphosis correction and neurological outcomes for patients undergoing cervical deformity correction surgery

2013 ◽  
Vol 18 (6) ◽  
pp. 537-544 ◽  
Author(s):  
Matthew J. Grosso ◽  
Roy Hwang ◽  
Thomas Mroz ◽  
Edward Benzel ◽  
Michael P. Steinmetz
Keyword(s):  
Cervical Spine ◽  
Deformity Correction ◽  
Neurological Symptoms ◽  
Neurological Dysfunction ◽  
Radiographic Findings ◽  
Cervical Deformity ◽  
Neurological Outcomes ◽  
Kyphosis Correction ◽  
Improved Outcomes ◽  
Correction Surgery

Object Reversal of the normal cervical spine curvature, as seen in cervical kyphosis, can lead to mechanical pain, neurological dysfunction, and functional disabilities. Surgical intervention is warranted in patients with sufficiently symptomatic deformities in an attempt to correct the deformed cervical spine. In theory, improved outcomes should accompany a greater degree of correction toward lordosis, although there are few data available to test this relationship. The purpose of this study is to determine if the degree of deformity correction correlates with improvement in neurological symptoms following surgery for cervical kyphotic deformity. Methods A retrospective review of 36 patients with myelopathic symptoms who underwent cervical deformity correction surgery between 2001 and 2009 was performed. Preoperative and postoperative radiographic findings related to the degree of kyphosis were collected and compared with functional outcome measures. The minimum follow-up time was 2 years. Results A significant relationship was observed between a greater degree of focal kyphosis correction and improved neurological outcomes according to the modified Japanese Orthopaedic Association (mJOA) score (r = −0.46, p = 0.032). For patients with severe neurological symptoms (mJOA score < 12) a trend toward improved outcomes with greater global kyphosis correction was observed (r = −0.56, p = 0.057). Patients with an mJOA score less than 16 who attained lordosis postoperatively had a significantly greater improvement in total mJOA score than patients who maintained a kyphotic position (achieved lordosis: 2.7 ± 2.0 vs maintained kyphosis: 1.1 ± 2.1, p = 0.044). Conclusions The authors' results suggest that the degree of correction of focal kyphosis deformity correlates with improved neurological outcomes. The authors also saw a positive relationship between attainment of global lordosis and improved mJOA scores. With consideration for the risks involved in correction surgery, this information can be used to help guide surgical strategy decision making.

Cervical Lordosis: The Significance of Decreased, Straightened, and Reversed Curves

2015 ◽  
Vol 20 (6) ◽  
pp. 3-5
Author(s):  
Charles N. Brooks ◽  
Marjorie Eskay-Auerbach ◽  
James B. Talmage ◽  
Allan F. Tencer
Keyword(s):  
Cervical Spine ◽  
Sagittal Plane ◽  
Coronal Plane ◽  
Spine Deformity ◽  
Cervical Lordosis ◽  
Normal Range ◽  
Cervical Kyphosis ◽  
X Ray ◽  
Horizontal Gaze ◽  
Over Time

Abstract The normal cervical spine is straight in the coronal plane and usually is lordotic (curved convex anteriorly) in the sagittal plane, and although cervical spine deformity occurs in the coronal plane (eg, scoliosis), sagittal plane deformities are more common. For example, cervical lordosis can be increased (hyperlordosis) within the normal range, decreased (hypolordosis), absent (a straight cervical spine with 0° of curvature on a lateral X ray), or reversed (kyphosis). Primary deformity of the cervical spine often is congenital (eg, wedge vertebra); secondary sagittal deformities may be due to disc degeneration accompanying aging, disease such as ankylosing spondylitis, or surgery (eg, for postlaminectomy kyphosis). Decreased, straightened, or reversed cervical lordosis (DSRCL) may be idiopathic and can be voluntary, and evaluators must differentiate DSRCL that does not change over time vs sagittal plane alignment that varies over time or with a change in posture or position. DSRCL usually is asymptomatic, but severe cervical kyphosis can cause neck pain, myelopathy, dysphagia, loss of horizontal gaze, and other symptoms that are sufficiently severe to result in disability and to require surgical correction. Reports of DSRCL due to spasm, particularly at times temporally remote to an injury, should be met with extreme skepticism. Kyphosis of sufficient severity to be symptomatic usually is a postoperative deformity, not an effect of whiplash.

scholarly journals Sagittal balance of the cervical spine

2021 ◽  
Vol 29 (1_suppl) ◽  
pp. 230949902110244
Author(s):  
Justin K Scheer ◽  
Darryl Lau ◽  
Christopher P Ames
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Sagittal Balance ◽  
Treatment Options ◽  
Complication Rates ◽  
Rapid Rate ◽  
Cervical Deformity ◽  
Cervical Sagittal Balance ◽  
Surgical Options ◽  
Conservative And Surgical Treatment

The treatment of adult cervical deformity continues to be complex with high complication rates. However there are many new advancements and overall patients do well following surgical correction. To date there are now many types of cervical deformity that have been classified and there exists a variety of surgical options. These recent advances have been developed in the last few years and the field continues to grow at a rapid rate. Thus, the goal of this article is to provide an updated review of cervical sagittal balance including; cervical alignment parameters, deformity classification, clinical evaluation, with both conservative and surgical treatment options.

Cervical Spine Deformity Correction: An Overview

2016 ◽  
Vol 91 ◽  
pp. 640-641 ◽  
Author(s):  
Regunath Kandasamy ◽  
Jafri Malin Abdullah
Keyword(s):  
Cervical Spine ◽  
Deformity Correction ◽  
Spine Deformity

Outcomes after surgery for cervical spine deformity: review of the literature

2010 ◽  
Vol 28 (3) ◽  
pp. E14 ◽  
Author(s):  
Arnold B. Etame ◽  
Anthony C. Wang ◽  
Khoi D. Than ◽  
Frank La Marca ◽  
Paul Park
Keyword(s):  
Neurological Complication ◽  
Functional Limitation ◽  
Deformity Correction ◽  
Neurological Deficits ◽  
Spine Deformity ◽  
Cervical Kyphosis ◽  
Radiographic Outcomes ◽  
Pubmed Database ◽  
Effective Option ◽  
Horizontal Gaze

Object Symptomatic cervical kyphosis can result from a variety of causes. Symptoms can include pain, neurological deficits, and functional limitation due to loss of horizontal gaze. Methods The authors review the long-term functional and radiographic outcomes following surgery for symptomatic cervical kyphosis by performing a PubMed database literature search. Results Fourteen retrospective studies involving a total of 399 patients were identified. Surgical intervention included ventral, dorsal, or circumferential approaches. Analysis of the degree of deformity correction and functional parameters demonstrated significant postsurgical improvement. Overall, patient satisfaction appeared high. Five studies reported mortality with rates ranging from 3.1 to 6.7%. Major medical complications after surgery were reported in 5 studies with rates ranging from 3.1 to 44.4%. The overall neurological complication rate was 13.5%. Conclusions Although complications are not insignificant, surgery appears to be an effective option when conservative measures fail to provide relief.

scholarly journals Cervical spine alignment, sagittal deformity, and clinical implications

2013 ◽  
Vol 19 (2) ◽  
pp. 141-159 ◽  
Author(s):  
Justin K. Scheer ◽  
Jessica A. Tang ◽  
Justin S. Smith ◽  
Frank L. Acosta ◽  
Themistocles S. Protopsaltis ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Myelopathy ◽  
Sagittal Alignment ◽  
Deformity Correction ◽  
Adjacent Segment ◽  
Sagittal Vertical Axis ◽  
Cervical Alignment ◽  
Cervical Deformity ◽  
Cervical Sagittal Alignment ◽  
Global Sagittal Alignment

This paper is a narrative review of normal cervical alignment, methods for quantifying alignment, and how alignment is associated with cervical deformity, myelopathy, and adjacent-segment disease (ASD), with discussions of health-related quality of life (HRQOL). Popular methods currently used to quantify cervical alignment are discussed including cervical lordosis, sagittal vertical axis, and horizontal gaze with the chin-brow to vertical angle. Cervical deformity is examined in detail as deformities localized to the cervical spine affect, and are affected by, other parameters of the spine in preserving global sagittal alignment. An evolving trend is defining cervical sagittal alignment. Evidence from a few recent studies suggests correlations between radiographic parameters in the cervical spine and HRQOL. Analysis of the cervical regional alignment with respect to overall spinal pelvic alignment is critical. The article details mechanisms by which cervical kyphotic deformity potentially leads to ASD and discusses previous studies that suggest how postoperative sagittal malalignment may promote ASD. Further clinical studies are needed to explore the relationship of cervical malalignment and the development of ASD. Sagittal alignment of the cervical spine may play a substantial role in the development of cervical myelopathy as cervical deformity can lead to spinal cord compression and cord tension. Surgical correction of cervical myelopathy should always take into consideration cervical sagittal alignment, as decompression alone may not decrease cord tension induced by kyphosis. Awareness of the development of postlaminectomy kyphosis is critical as it relates to cervical myelopathy. The future direction of cervical deformity correction should include a comprehensive approach in assessing global cervicalpelvic relationships. Just as understanding pelvic incidence as it relates to lumbar lordosis was crucial in building our knowledge of thoracolumbar deformities, T-1 incidence and cervical sagittal balance can further our understanding of cervical deformities. Other important parameters that account for the cervical-pelvic relationship are surveyed in detail, and it is recognized that all such parameters need to be validated in studies that correlate HRQOL outcomes following cervical deformity correction.

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