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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
저자정보
Katherine E. Pierce (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Peter G. Passias (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Avery E. Brown (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Cole A. Bortz (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Haddy Alas (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Lara Passfall (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Oscar Krol (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Nicholas Kummer (Departments of Orthopaedic and Neurologic Surgery NYU Langone Orthopedic Hospital New York Spine) Renaud Lafage (Hospital for Special Surgery) Dean Chou (Department of Neurological Surgery University of California San Francisco) Douglas C. Burton (Department of Orthopedic Surgery University of Kansas Medical Center) Breton Line (Rocky Mountain Scoliosis and Spine) Eric Klineberg (University of California Davis) Robert Hart (Department of Orthopaedic Surgery Swedish Neuroscience Institute) Jeffrey Gum (Norton Leatherman Spine Center) Alan Daniels (Department of Orthopaedic Surgery Warren Alpert School of Medicine Brown University) Kojo Hamilton (Department of Neurological Surgery University of Pittsburgh School of Medicine) Shay Bess (Rocky Mountain Hospital for Children) Themistocles Protopsaltis (Department of Orthopaedics NYU Langone Orthopedic Hospital) Christopher Shaffrey (Departments of Neurosurgery and Orthopaedic Surgery Duke University Medical Center) Frank A. Schwab (Department of Orthopedics Hospital for Special Surgery) Justin S. Smith (Department of Neurosurgery University of Virginia) Virginie Lafage (Hospital for Special Surgery) Christopher Ames (Department of Neurosurgery University of California San Francisco) International Spine Study Group (ISSG) (International Spine Study Group (ISSG))
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제3호
발행연도
2021.9
수록면
506 - 514 (9page)
DOI
10.14245/ns.2040540.270

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초록· 키워드

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Objective: To prioritize the cervical parameter targets for alignment. Methods: Included: cervical deformity (CD) patients (C2?7 Cobb angle>10°, cervical lordosis>10°, cervical sagittal vertical axis [cSVA]>4 cm, or chin-brow vertical angle>25°) with full baseline (BL) and 1-year (1Y) radiographic parameters and Neck Disability Index (NDI) scores; patients with cervical [C] or cervicothoracic [CT] Primary Driver Ames type. Patients with BL Ames classified as low CD for both parameters of cSVA (<4 cm) and T1 slope minus cervical lordosis (TS?CL) (<15°) were excluded. Patients assessed: meeting minimum clinically important differences (MCID) for NDI (<-15 ΔNDI). Ratios of correction were found for regional parameters categorized by primary Ames driver (C or CT). Decision tree analysis assessed cutoffs for differences associated with meeting NDI MCID at 1Y. Results: Seventy-seven CD patients (mean age, 62.1 years; 64% female; body mass index, 28.8 kg/m2). Forty-one point six percent of patients met MCID for NDI. A backwards linear regression model including radiographic differences as predictors from BL to 1Y for meeting MCID for NDI demonstrated an R2 of 0.820 (p=0.032) included TS?CL, cSVA, McGregor’s slope (MGS), C2 sacral slope, C2?T3 angle, C2?T3 SVA, cervical lordosis. By primary Ames driver, 67.5% of patients were C, and 32.5% CT. Ratios of change in predictors for MCID NDI patients for C and CT were not significant between the 2 groups (p> 0.050). Decision tree analysis determined cutoffs for radiographic change, prioritizing in the following order: ≥42.5° C2?T3 angle, >35.4° cervical lordosis, <-31.76° C2 slope, <-11.57-mm cSVA, <-2.16° MGS, >-30.8-mm C2?T3 SVA, and ≤-33.6° TS?CL. Conclusion: Certain ratios of correction of cervical parameters contribute to improving neck disability. Prioritizing these radiographic alignment parameters may help optimize patient-reported outcomes for patients undergoing CD surgery.
#Spine #Cervical deformity #Alignment

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참고문헌 (31)

참고문헌 신청
Smith JS / 2017 / The health impact of adult cervical deformity in patients presenting for surgical treatment: comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire / Neurosurgery 80:716~725 google schola Chi JH / 2007 / Complex deformities of the cervical spine / Neurosurg Clin N Am 18:295~304 google schola Grob D / 2007 / The association between cervical spine curvature and neck pain / Eur Spine J 16:669~678 google schola Ames CP / 2012 / Impact of spinopelvic alignment on decision making in deformity surgery in adults:a review / J Neurosurg Spine 16:547~564 google schola Hallager DW / 2016 / A comprehensive analysis of the SRS-Schwab Adult Spinal Deformity Classification and confounding variables - a prospective, non-US cross-sectional study in 292 patients / Spine 41:E589~E597 google schola

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