Evaluating intraoperative C2 slope as a radiographic guide for cervical deformity correction

Area of Science:

• Orthopedic Surgery
• Spine Deformity Correction
• Radiographic Measurement

Background:

• Optimal sagittal alignment is crucial in cervical deformity correction.
• Reliable intraoperative tools for guiding cervical spine alignment are limited.
• C2 slope (C2S) is a parameter reflecting upper thoracic and cervical spine relationship, linked to quality of life.

Purpose of the Study:

• To investigate the role of intraoperative C2 slope (C2S) as a guide for cervical deformity correction.
• To assess the stability of C2S and T1 slope minus cervical lordosis (T1S-CL) after correction.
• To evaluate the correlation between radiographic parameters and clinical outcomes.

Main Methods:

• Analysis of 45 patients with cervical deformity and minimum 2-year follow-up.
• Intraoperative lateral radiographs used to measure C2S for surgical guidance.
• Evaluation of radiographic parameters (C2S, C2-7 lordosis, T1 slope, T1S-CL, sagittal vertical axis) preoperatively, intraoperatively, and postoperatively.
• Assessment of clinical outcomes including pain, disability, and quality of life scores.

Main Results:

• Significant correction and stable maintenance of C2S and T1S-CL were observed postoperatively and during follow-up.
• Final C2S and T1S-CL showed significant correlations with improved clinical outcomes.
• Intraoperative C2S measurement guided surgical adjustments effectively.

Conclusions:

• Intraoperative C2 slope (C2S) is a practical reference for guiding cervical deformity correction.
• Using C2S can lead to favorable radiographic and clinical outcomes in cervical deformity surgery.
• C2S measurement aids in achieving and maintaining optimal sagittal alignment.