Journal of Craniovertebral Junction and Spine

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 13  |  Issue : 1  |  Page : 67--71

Do the newly proposed realignment targets bridge the gap between radiographic and clinical success in adult cervical deformity corrective surgery


Katherine E Pierce1, Oscar Krol1, Jordan Lebovic1, Nicholas Kummer1, Lara Passfall1, Waleed Ahmad1, Sara Naessig1, Bassel Diebo2, Peter Gust Passias1 
1 Department of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, Brooklyn, NY, USA
2 Department of Orthopedics, SUNY Downstate, Brooklyn, NY, USA

Correspondence Address:
Peter Gust Passias
Division of Spinal Surgery/Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, New York, NY
USA

Hypothesis: The myelopathy-based cervical deformity (CD) thresholds will associate with patient-reported outcomes and complications. Materials and Methods: This study include CD patients (C2-C7 Cobb > 10°, CL > 10°, cervical sagittal vertical axis > 4 cm, or CBVA > 25°) with BL and 1-year (1Y) data. Modifiers assessed low (L), moderate (M), and severe (S) deformity: CL (L: >3°; M:-21° to 3°; S: <‒21°), TS-CL (L: <26°; M: 26° to 45°; S: >45°), C2-T3 angle (L: >‒25°; M:-35° to-25°; S: <‒35°), C2 slope (L: <33°; M: 33° to 49°; S: >49°), MGS (L: >‒9° and < 0°; M: ‒12° to ‒9° or 0° to 19°; S: < ‒12° or > 19°), and frailty (L: <0.18; M: 0.18–0.27, S: >0.27). Means comparison and ANOVA assessed outcomes in the severity groups at BL at 1Y. Correlations found between modifiers assessed the internal relationship. Results: One hundred and four patients were included in the study (57.1 years, 50%, 29.3 kg/m2). Baseline S TS-CL, C2-T3, and C2S modifiers were associated with increased reoperations (P < 0.01), while S MGS, CL, and C2-T3 had increased estimated blood lost (>1000ccs, P < 0.001). S MGS and C2-T3 had more postop DJK (60%, P = 0.018). Improvement in TS-CL, C2S, C2-T3, and CL patients had better numeric rating scale (NRS) back (<5) and EuroQOL 5-Dimension questionnaire (EQ5D) at 1 year (P < 0.05). Improving the modifiers correlated strongly with each other (0.213–0.785, P < 0.001). Worsened TS-CL had increased NRS back scores at 1 year (9, P = 0.042). Worsened CL had increased 1-year modified Japanese Orthopedic Association (mJOA) (7, P = 0.001). Worsened C2-T3 had worse NRS neck scores at 1 year (P = 0.048). Improvement in all six modifiers (8.7%) had significantly better health-related quality of life (HRQL) scores at follow-up (EQ5D, NRS, and Neck Disability Index). Conclusions: Newly proposed CD modifiers based on mJOA were closely associated with outcomes. Improvement and deterioration in the modifiers significantly impacted the HRQL.


How to cite this article:
Pierce KE, Krol O, Lebovic J, Kummer N, Passfall L, Ahmad W, Naessig S, Diebo B, Passias PG. Do the newly proposed realignment targets bridge the gap between radiographic and clinical success in adult cervical deformity corrective surgery.J Craniovert Jun Spine 2022;13:67-71


How to cite this URL:
Pierce KE, Krol O, Lebovic J, Kummer N, Passfall L, Ahmad W, Naessig S, Diebo B, Passias PG. Do the newly proposed realignment targets bridge the gap between radiographic and clinical success in adult cervical deformity corrective surgery. J Craniovert Jun Spine [serial online] 2022 [cited 2022 Nov 27 ];13:67-71
Available from: https://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=67;epage=71;aulast=Pierce;type=0