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Clinical significance of the C2 slope after multilevel cervical spine fusion

Authors
 Namhoo Kim  ;  Kyung-Soo Suk  ;  Ji-Won Kwon  ;  Joonoh Seo  ;  Hunjin Ju  ;  Byung Ho Lee  ;  Seong-Hwan Moon  ;  Hak-Sun Kim  ;  Hwan-Mo Lee 
Citation
 JOURNAL OF NEUROSURGERY-SPINE, Vol.38(1) : 24-30, 2023-01 
Journal Title
JOURNAL OF NEUROSURGERY-SPINE
ISSN
 1547-5654 
Issue Date
2023-01
MeSH
Cervical Vertebrae / diagnostic imaging ; Cervical Vertebrae / surgery ; Clinical Relevance ; Humans ; Lordosis* / diagnostic imaging ; Lordosis* / surgery ; Neck / surgery ; Neck Pain / diagnostic imaging ; Neck Pain / etiology ; Neck Pain / surgery ; Retrospective Studies ; Spinal Fusion*
Keywords
C2 slope ; T1 slope ; cervical sagittal vertical axis ; cervical spine ; clinical outcome ; sagittal alignment
Abstract
Objective: The C2 slope (C2S) is one of the parameters that can determine cervical sagittal alignment, but its clinical significance is relatively unexplored. This study aimed to evaluate the clinical significance of the C2S after multilevel cervical spine fusion.

Methods: A total of 111 patients who underwent multilevel cervical spine fusion were included in this study. The C2S, cervical sagittal vertical axis (cSVA), C2-7 lordosis, and T1 slope (T1S) were measured in standing lateral cervical spine radiographs preoperatively and 2 years after the surgery. Clinical outcome measures were visual analog scale (VAS) neck and arm pain scores, Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) scale score, and patient-reported subjective improvement rate (IR) percentage. Statistical analysis was performed using a paired-samples t-test and Pearson's correlation, and a receiver operating characteristic (ROC) curve to determine the cutoff values of C2S.

Results: C2S demonstrated a significant correlation with the cSVA, C2-7 lordosis, T1S, and T1S minus cervical lordosis. C2S revealed a significant correlation with the JOA, neck pain VAS, and NDI scores at 2 years after surgery. Change in the C2S correlated with postoperative neck pain and NDI scores. ROC curves demonstrated the cutoff values of C2S as 18.8°, 22.25°, and 25.35°, according to a cSVA of 40 mm, severe disability expressed by NDI, and severe myelopathy, respectively.

Conclusions: C2S can be an additional cervical sagittal alignment parameter that can be a useful prognostic factor after multilevel cervical spine fusion.
Full Text
https://thejns.org/spine/view/journals/j-neurosurg-spine/38/1/article-p24.xml
DOI
10.3171/2022.6.SPINE22588
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji-Won(권지원) ORCID logo https://orcid.org/0000-0003-4880-5310
Kim, Nam-Hoo(김남후)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Suk, Kyung Soo(석경수) ORCID logo https://orcid.org/0000-0003-0633-2658
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193535
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