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Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
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Analysis of Success Versus Poor Realignment in Patients with Cervical Deformity: In-Construct Angles Provide Novel
Themistocles Protopsaltis1, Samuel Ezeonu1, Fares Ani1
1NYU Langone Health, Department of Orthopedics.
Spine
|February 9, 2026
Summary
Intraoperative measurements of C2-LIV sagittal angles (SA) can predict cervical deformity (CD) correction outcomes. Under-correction, indicated by larger postoperative C2-LIV SA, is linked to failed alignment and DJK development.
Area of Science:
- Spine surgery
- Orthopedics
- Radiographic analysis
Background:
- Cervical deformity (CD) correction can improve patient function.
- Intraoperative radiographic parameters are needed for accurate CD correction.
- Current methods lack intraoperative measurement capabilities.
Purpose of the Study:
- Investigate in-construct measurements of sagittal angles (SA) from C2 to thoracic vertebrae.
- Establish SA targets for effective cervical deformity correction.
- Correlate intraoperative SA measurements with postoperative outcomes.
Main Methods:
- Multicenter prospective study of 143 patients with CD.
- In-construct SA measurements (C2-T1, C2-T4, C2-T10) were analyzed.
- Linear regression identified SA values corresponding to a 4 cm C2-SVA.
Main Results:
- 51% of patients experienced radiographic failure.
- Postoperative C2-T1 SA independently predicted failed alignment (OR=1.22).
- A 4 cm C2-SVA correlated with C2-T1 SA of -9.6° and C2-T10 SA of 14.7°.
Conclusions:
- Under-correction, indicated by larger postoperative in-construct angles, is associated with failed alignment and DJK.
- Intraoperative SA measurements can guide CD correction.
- Greater C2-LIV SA correction correlated with improved neck pain.
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