Relationship between T1 slope and cervical alignment following multilevel posterior cervical fusion surgery: Impact of T1 slope minus cervical lordosis

Seong Jae Hyun, Ki Jeong Kim, Hyun Jib Kim, Tae An Chang

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Study Design. Retrospective study. Objective. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). Summary of Background Data. A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. Methods. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. Results. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r=0.495). C2-C7 lordosis (P=0.001) and T1S-CL (P=0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r=0.871 and r=0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50mm corresponded to a T1S-CL value of 26.1°. Conclusion. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50mm.

Original languageEnglish
Pages (from-to)E396-E402
JournalSpine
Volume41
Issue number7
DOIs
StatePublished - 1 Jan 2016

Fingerprint

Lordosis
Neck
Spine
Quality of Life
Spinal Cord Diseases
Pathologic Constriction
Retrospective Studies
Regression Analysis

Keywords

  • Cervical lordosis
  • Health-related quality-of-life
  • Posterior cervical fusion
  • Sagittal alignment
  • Spinal deformity
  • T1 slope

Cite this

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title = "Relationship between T1 slope and cervical alignment following multilevel posterior cervical fusion surgery: Impact of T1 slope minus cervical lordosis",
abstract = "Study Design. Retrospective study. Objective. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). Summary of Background Data. A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. Methods. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. Results. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r=0.495). C2-C7 lordosis (P=0.001) and T1S-CL (P=0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r=0.871 and r=0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50mm corresponded to a T1S-CL value of 26.1°. Conclusion. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50mm.",
keywords = "Cervical lordosis, Health-related quality-of-life, Posterior cervical fusion, Sagittal alignment, Spinal deformity, T1 slope",
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Relationship between T1 slope and cervical alignment following multilevel posterior cervical fusion surgery : Impact of T1 slope minus cervical lordosis. / Hyun, Seong Jae; Kim, Ki Jeong; Kim, Hyun Jib; Chang, Tae An.

In: Spine, Vol. 41, No. 7, 01.01.2016, p. E396-E402.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between T1 slope and cervical alignment following multilevel posterior cervical fusion surgery

T2 - Impact of T1 slope minus cervical lordosis

AU - Hyun, Seong Jae

AU - Kim, Ki Jeong

AU - Kim, Hyun Jib

AU - Chang, Tae An

PY - 2016/1/1

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N2 - Study Design. Retrospective study. Objective. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). Summary of Background Data. A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. Methods. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. Results. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r=0.495). C2-C7 lordosis (P=0.001) and T1S-CL (P=0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r=0.871 and r=0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50mm corresponded to a T1S-CL value of 26.1°. Conclusion. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50mm.

AB - Study Design. Retrospective study. Objective. To assess the relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life scores following multilevel posterior cervical fusion, and to explore whether an analogous relationship exists in the cervical spine using T1 slope minus C2-C7 lordosis (T1S-CL). Summary of Background Data. A recent study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery. Methods. From 2007 to 2013, 38 consecutive patients underwent multilevel posterior cervical fusion for cervical stenosis, myelopathy, and deformities. Radiographic measurements included C0-C2 lordosis, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope, and T1S-CL. Pearson correlation coefficients were calculated between pairs of radiographic measures and health-related quality-of-life. Results. C2-C7 SVA positively correlated with neck disability index (NDI) scores (r=0.495). C2-C7 lordosis (P=0.001) and T1S-CL (P=0.002) changes correlated with NDI score changes after surgery. For significant correlations between C2-C7 SVA and NDI scores, regression models predicted a threshold C2-C7 SVA value of 50mm, beyond which correlations were most significant. The T1S-CL also correlated positively with C2-C7 SVA and NDI scores (r=0.871 and r=0.470, respectively). Results of the regression analysis indicated that a C2-C7 SVA value of 50mm corresponded to a T1S-CL value of 26.1°. Conclusion. This study showed that disability of the neck increased with cervical sagittal malalignment following surgical reconstruction and a greater T1S-CL mismatch was associated with a greater degree of cervical malalignment. Specifically, a mismatch greater than 26.1° corresponded to positive cervical sagittal malalignment, defined as C2-C7 SVA greater than 50mm.

KW - Cervical lordosis

KW - Health-related quality-of-life

KW - Posterior cervical fusion

KW - Sagittal alignment

KW - Spinal deformity

KW - T1 slope

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