Effect of correction surgery for cervical kyphosis on compensatory mechanisms in overall spinopelvic sagittal alignment
Abstract
Purpose
Progression of kyphotic deformity at the middle/lower cervical spine can cause difficulty with horizontal gaze, so compensation at other spinopelvic parts may occur. However, the precise mechanism remains unclear. The present study investigated the effect of correction surgery for cervical kyphosis on the compensatory mechanisms in overall spinopelvic sagittal alignment.
Methods
Forty-one patients, comprising 23 males and 18 females (mean age 67 years), underwent correction surgery for cervical kyphosis using the posterior screw–rod system. Spinopelvic lateral radiographs in the standing position were taken before and after surgery. C0–1 angle, C1–2 angle, clivo-axial angle (CAA), C2–7 angle, thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope were measured. Correlations between C2–7 angle and these parameters before surgery, and correlations between the correction angle of cervical kyphosis and postoperative changes of these parameters were evaluated.
Results
Negative correlations were found between the C2–7 angle and CAA (R = −0.640, p < 0.01), and C2–7 angle and C0–1 angle (R = −0.762, p < 0.001) before surgery. Negative correlations were found between the correction angle of C2–7 and change of CAA (R = −0.718, p < 0.001), and between the correction angle of C2–7 and change of C0–1 angle (R = −0.672, p < 0.01) after surgery.
Conclusions
The present study demonstrated that C0–1 angle and CAA are more important in the compensatory mechanism for kyphotic deformity at the middle/lower cervical spine compared to downward parameters. That is, to maintain horizontal gaze, lordosis increases at the cranio-cervical junction with greater kyphosis at the middle/lower cervical spine. Correction of cervical kyphosis in the middle/lower cervical spine resulted in normalization of the C0–1 angle and CAA because the compensatory mechanism at the cranio-cervical junction for obtaining horizontal gaze was no longer necessary after surgical intervention.
Publisher URL: https://link.springer.com/article/10.1007/s00586-017-5106-7
DOI: 10.1007/s00586-017-5106-7
Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.
Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.