Reciprocal changes in cervical spine alignment after corrective thoracolumbar deformity surgery

Area of Science:

• Spine surgery
• Orthopedics
• Deformity correction

Background:

• Thoracolumbar deformity significantly impacts spinal alignment.
• Cervical spine alignment can be affected by thoracolumbar corrective surgery.
• Understanding these changes is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To identify changes in cervical alignment after thoracolumbar deformity surgery.
• To assess which preoperative parameters influence postoperative cervical alignment.

Main Methods:

• Retrospective study of 49 patients with thoracolumbar deformity.
• Comparison of cervical spine parameters in low (C7 SVA ≤ 6 cm) and high (C7 SVA ≥ 9 cm) preoperative C7 sagittal vertical axis groups.
• Multilinear regression analysis to determine relationships between preoperative parameters, surgical plans, and postoperative cervical lordosis.

Main Results:

• Patients with lower preoperative C7 SVA showed increased cervical lordosis post-surgery.
• Patients with higher preoperative C7 SVA exhibited decreased cervical lordosis post-surgery.
• Preoperative C2-7 angle, T1 slope, pelvic tilt (PT) surgical plan, and C7 SVA were identified as determinants of postoperative cervical lordosis.

Conclusions:

• Preoperative spinal alignment and surgical strategy are key factors influencing postoperative cervical alignment in spinal deformity surgery.
• These findings aid in predicting and managing cervical changes during thoracolumbar correction.