Cargando…
Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy?
OBJECTIVE: It remains unclear whether cervical sagittal deformity (CSD) should be defined by radiographic parameters alone versus both clinical and radiographic factors, and whether radiographic malalignment by itself warrants a CSD corrective surgery in patients who present primarily with neurologi...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Spinal Neurosurgery Society
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816587/ https://www.ncbi.nlm.nih.gov/pubmed/36597623 http://dx.doi.org/10.14245/ns.2244924.462 |
_version_ | 1784864569313722368 |
---|---|
author | Nemani, Venu M. Louie, Philip K. Drolet, Caroline E. Rhee, John M. |
author_facet | Nemani, Venu M. Louie, Philip K. Drolet, Caroline E. Rhee, John M. |
author_sort | Nemani, Venu M. |
collection | PubMed |
description | OBJECTIVE: It remains unclear whether cervical sagittal deformity (CSD) should be defined by radiographic parameters alone versus both clinical and radiographic factors, and whether radiographic malalignment by itself warrants a CSD corrective surgery in patients who present primarily with neurologic symptoms. METHODS: We administered a survey to a group of expert surgeons to evaluate whether radiographic parameters alone were sufficient to diagnose CSD, and in which scenarios surgeons recommend a CSD realignment procedure versus addressing the neurologic symptoms alone. RESULTS: No single radiographic criteria reached a 50% threshold as being sufficient to establish the diagnosis of CSD. When asymptomatic radiographic malalignment was present, a sagittal deformity correction was more likely to be recommended in patients with myelopathy versus those with radiculopathy alone. The majority of surgeons recommended deformity correction when symptoms of cervical deformity were present in addition to radiographic malalignment (85% with deformity symptoms and radiculopathy, 93% with deformity symptoms and myelopathy). CONCLUSION: There is no consensus on which radiographic and/or clinical criteria are necessary to define the presence of CSD. We recommend that symptoms of cervical deformity, in addition to radiographic parameters, be considered when deciding whether to perform deformity correction in patients who present primarily with myelopathy or radiculopathy. |
format | Online Article Text |
id | pubmed-9816587 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Korean Spinal Neurosurgery Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-98165872023-01-11 Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? Nemani, Venu M. Louie, Philip K. Drolet, Caroline E. Rhee, John M. Neurospine Original Article OBJECTIVE: It remains unclear whether cervical sagittal deformity (CSD) should be defined by radiographic parameters alone versus both clinical and radiographic factors, and whether radiographic malalignment by itself warrants a CSD corrective surgery in patients who present primarily with neurologic symptoms. METHODS: We administered a survey to a group of expert surgeons to evaluate whether radiographic parameters alone were sufficient to diagnose CSD, and in which scenarios surgeons recommend a CSD realignment procedure versus addressing the neurologic symptoms alone. RESULTS: No single radiographic criteria reached a 50% threshold as being sufficient to establish the diagnosis of CSD. When asymptomatic radiographic malalignment was present, a sagittal deformity correction was more likely to be recommended in patients with myelopathy versus those with radiculopathy alone. The majority of surgeons recommended deformity correction when symptoms of cervical deformity were present in addition to radiographic malalignment (85% with deformity symptoms and radiculopathy, 93% with deformity symptoms and myelopathy). CONCLUSION: There is no consensus on which radiographic and/or clinical criteria are necessary to define the presence of CSD. We recommend that symptoms of cervical deformity, in addition to radiographic parameters, be considered when deciding whether to perform deformity correction in patients who present primarily with myelopathy or radiculopathy. Korean Spinal Neurosurgery Society 2022-12 2022-12-31 /pmc/articles/PMC9816587/ /pubmed/36597623 http://dx.doi.org/10.14245/ns.2244924.462 Text en Copyright © 2022 by the Korean Spinal Neurosurgery Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Nemani, Venu M. Louie, Philip K. Drolet, Caroline E. Rhee, John M. Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title | Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title_full | Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title_fullStr | Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title_full_unstemmed | Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title_short | Defining Cervical Sagittal Plane Deformity – When Are Sagittal Realignment Procedures Necessary in Patients Presenting Primarily With Radiculopathy or Myelopathy? |
title_sort | defining cervical sagittal plane deformity – when are sagittal realignment procedures necessary in patients presenting primarily with radiculopathy or myelopathy? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816587/ https://www.ncbi.nlm.nih.gov/pubmed/36597623 http://dx.doi.org/10.14245/ns.2244924.462 |
work_keys_str_mv | AT nemanivenum definingcervicalsagittalplanedeformitywhenaresagittalrealignmentproceduresnecessaryinpatientspresentingprimarilywithradiculopathyormyelopathy AT louiephilipk definingcervicalsagittalplanedeformitywhenaresagittalrealignmentproceduresnecessaryinpatientspresentingprimarilywithradiculopathyormyelopathy AT droletcarolinee definingcervicalsagittalplanedeformitywhenaresagittalrealignmentproceduresnecessaryinpatientspresentingprimarilywithradiculopathyormyelopathy AT rheejohnm definingcervicalsagittalplanedeformitywhenaresagittalrealignmentproceduresnecessaryinpatientspresentingprimarilywithradiculopathyormyelopathy |