Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Deformity Correction

Background:

• Craniocervical junction (CVJ) kyphosis with negative sagittal imbalance presents complex challenges.
• Effective surgical strategies are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate clinical outcomes of craniocervical realignment surgery for CVJ kyphosis and negative sagittal imbalance.
• To identify radiological predictors of favorable surgical outcomes.

Main Methods:

• Retrospective analysis of 28 patients undergoing craniocervical realignment (2014-2022).
• Clinical outcomes assessed via Neck Disability Index (NDI), visual analogue scale (VAS) for neck pain, and Japanese Orthopaedic Association (JOA) score.
• Radiographic parameters included C0-2 angle and C2-7 sagittal vertical axis (SVA); regression and ROC analyses were used.

Main Results:

• Craniocervical realignment significantly improved clinical and radiographic parameters.
• Greater postoperative C0-2 angle and C2-7 SVA changes correlated with better outcomes.
• Changes in C0-2 angle and C2-7 SVA were independent predictors of NDI improvement.

Conclusions:

• Craniocervical realignment is a viable surgical option for CVJ kyphosis with negative sagittal imbalance.
• Postoperative C0-2 angle and C2-7 SVA changes are associated with favorable clinical and functional outcomes.
• These radiographic changes may serve as important prognostic factors.