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How Cervical Reconstruction Surgery Affects Global Spinal Alignment.

Jun Mizutani1,2, Russell Strom2, Kuniyoshi Abumi3

  • 1Department of Rehabilitation Medicine and Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

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|May 3, 2018
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Summary
This summary is machine-generated.

Cervical reconstruction surgery can improve global spinal alignment (GSA) by achieving occiput-trunk concordance. Thoracolumbar alignment adjusts as needed, but surgeons must weigh risks and benefits.

Keywords:
Cervical kyphotic deformityCervical spine reconstructionGlobal spinal alignmentOcciput-trunk concordanceSagittal vertical axisSpinal deformity

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Global spinal alignment

Background:

  • Cervical reconstruction surgery's impact on global spinal alignment (GSA) is not well-documented.
  • Understanding this relationship is crucial for surgical planning and patient outcomes.

Purpose of the Study:

  • To investigate how cervical reconstruction surgery influences GSA.
  • To determine if achieving cervical sagittal balance impacts thoracolumbar alignment.

Main Methods:

  • Retrospective multicenter study of 78 patients with cervical kyphosis undergoing cervical reconstruction.
  • Patients categorized by head/trunk balance (C7 plumb line) and cervical sagittal balance (C2-C7 plumb line distance).
  • Measurements included sagittal Cobb angles and sagittal vertical axes pre- and post-surgery.

Main Results:

  • Cervical alignment improved to achieve occiput-trunk concordance (<30 mm C7 plumb line to COG plumb line).
  • Significant thoracolumbar alignment changes occurred in head-balanced and cervical sagittal imbalanced groups.
  • Trunk-balanced and cervical sagittal balanced groups showed no significant thoracolumbar changes. Neurological worsening occurred in 2 cases.

Conclusions:

  • The primary aim of cervical reconstruction is occiput-trunk concordance for harmonizing GSA.
  • Cervical reconstruction can correct both cervical deformity and GSA.
  • Surgeons must carefully consider the risks and benefits of these complex procedures.