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A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years.

Publication ,  Journal Article
Jalai, CM; Passias, PG; Lafage, V; Smith, JS; Lafage, R; Poorman, GW; Diebo, B; Liabaud, B; Neuman, BJ; Scheer, JK; Shaffrey, CI; Bess, S ...
Published in: Eur Spine J
August 2016

PURPOSE: Characteristics specific to cervical deformity (CD) concomitant with adult thoracolumbar deformity (TLD) remains uncertain, particularly regarding treatment. This study identifies cervical malalignment prevalence following surgical and conservative TLD treatment through 2 years. METHODS: Retrospective analysis of a prospective, multicenter adult spinal deformity (ASD) database. CD was defined in operative and non-operative ASD patients according to the following criteria: T1 Slope minus Cervical Lordosis (T1S-CL) ≥20°, C2-C7 Cervical Sagittal Vertical Axis (cSVA) ≥40 mm, C2-C7 kyphosis >10°. Differences in rates, demographics, health-related quality of life (HRQoL) scores for Oswestry Disability Index (ODI) and Scoliosis Research Society Questionnaire (SRS-22r), and radiographic variables were assessed between treatment groups (Op vs. Non-Op) and follow-up periods (baseline, 1-year, 2-year). RESULTS: Three hundred and nineteen (200 Op, 199 Non-Op) ASD patients were analyzed. Op patients' CD rates at 1 and 2 years were 78.9, and 63.0 %, respectively. Non-Op CD rates were 21.1 and 37.0 % at 1 and 2 years, respectively. T1S-CL mismatch and cSVA malalignment characterized Op CD at 1 and 2 years (p < 0.05). Op and Non-Op CD groups had similar cervical/global alignment at 1 year (p > 0.05 for all), but at 2 years, Op CD patients had worse thoracic kyphosis (TK), T1S-CL, CL, cSVA, C2-T3 SVA, and global SVA compared to Non-Ops (p < 0.05). Op CD patients had worse ODI, and SRS Activity at 1 and 2 years post-operative (p < 0.05), but had greater 2-year SRS Satisfaction scores (p = 0.019). CONCLUSIONS: In the first study to compare cervical malalignment at extended follow-up between ASD treatments, CD rates rose overall through 2 years. TLD surgery, resulting in higher CD rates characterized by T1S-CL and cSVA malalignment, produced poorer HRQoL. This information can aid in treatment method decision-making when cervical deformity is present concomitant with TLD.

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Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

August 2016

Volume

25

Issue

8

Start / End Page

2423 / 2432

Location

Germany

Related Subject Headings

  • Thoracic Vertebrae
  • Surveys and Questionnaires
  • Spinal Diseases
  • Scoliosis
  • Retrospective Studies
  • Quality of Life
  • Prevalence
  • Postoperative Period
  • Patient Satisfaction
  • Orthopedics
 

Citation

APA
Chicago
ICMJE
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Jalai, C. M., Passias, P. G., Lafage, V., Smith, J. S., Lafage, R., Poorman, G. W., … International Spine Study Group (ISSG), . (2016). A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years. Eur Spine J, 25(8), 2423–2432. https://doi.org/10.1007/s00586-016-4564-7
Jalai, Cyrus M., Peter G. Passias, Virginie Lafage, Justin S. Smith, Renaud Lafage, Gregory W. Poorman, Bassel Diebo, et al. “A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years.Eur Spine J 25, no. 8 (August 2016): 2423–32. https://doi.org/10.1007/s00586-016-4564-7.
Jalai CM, Passias PG, Lafage V, Smith JS, Lafage R, Poorman GW, Diebo B, Liabaud B, Neuman BJ, Scheer JK, Shaffrey CI, Bess S, Schwab F, Ames CP, International Spine Study Group (ISSG). A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years. Eur Spine J. 2016 Aug;25(8):2423–2432.
Journal cover image

Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

August 2016

Volume

25

Issue

8

Start / End Page

2423 / 2432

Location

Germany

Related Subject Headings

  • Thoracic Vertebrae
  • Surveys and Questionnaires
  • Spinal Diseases
  • Scoliosis
  • Retrospective Studies
  • Quality of Life
  • Prevalence
  • Postoperative Period
  • Patient Satisfaction
  • Orthopedics