The morphology of cervical deformities: a two-step cluster analysis to identify cervical deformity patterns
Han Jo Kim1, Sohrab Virk1, Jonathan Elysee1
11Department of Orthopedics, Hospital for Special Surgery, New York.
Journal of Neurosurgery. Spine
|November 16, 2019
Summary
Three distinct patterns of cervical deformity (CD) were identified: flat neck, focal deformity, and cervicothoracic deformity. Extension radiographs were key to differentiating these sagittal malalignment patterns in patients with CD.
Area of Science:
- Orthopedics
- Spine Surgery
- Radiology
Background:
- Cervical deformity (CD) presents challenges in definition due to normal alignment variability.
- Postural and thoracolumbar changes significantly influence cervical alignment.
Purpose of the Study:
- To establish patterns of sagittal cervical deformity.
- To analyze neutral and dynamic radiographic alignment in CD patients.
Main Methods:
- Retrospective review of a prospective, multicenter CD surgical database (2013-2015).
- Consensus-based radiographic review by 12 individuals to identify severe sagittal CD.
- Two-step cluster analysis of radiographic parameters correlated with quality of life.
Main Results:
- 75 patients with severe sagittal cervical deformity were analyzed.
- Three distinct patterns identified: flat neck, focal deformity, and cervicothoracic deformity.
- Significant correlations found between spinal alignment, flexibility, and quality of life metrics.
Conclusions:
- Identified three distinct sagittal cervical deformity patterns: flat neck, focal deformity, and cervicothoracic deformity.
- Extension radiographs are crucial for differentiating these patterns.
- Findings provide a foundation for a CD classification system to guide surgical treatment.
