PT  - JOURNAL ARTICLE
AU  - Passias, Peter G.
AU  - Jalai, Cyrus M.
AU  - Worley, Nancy
AU  - Vira, Shaleen
AU  - Scheer, Justin K.
AU  - Smith, Justin S.
AU  - Ramachandran, Subaraman
AU  - Soroceanu, Alexandra
AU  - Horn, Samantha R.
AU  - Poorman, Gregory W.
AU  - Protopsaltis, Themistocles S.
AU  - Klineberg, Eric O.
AU  - Sciubba, Daniel M.
AU  - Kim, Han Jo
AU  - Hamilton, D. Kojo
AU  - Lafage, Renaud
AU  - Lafage, Virginie
AU  - Ames, Christopher P.
AU  - ,
TI  - Development of New-Onset Cervical Deformity in Nonoperative Adult Spinal Deformity Patients With 2-Year Follow-Up
AID  - 10.14444/5091
DP  - 2018 Dec 01
TA  - International Journal of Spine Surgery
PG  - 5091
4099  - https://www.ijssurgery.com/content/early/2018/12/11/5091.short
4100  - https://www.ijssurgery.com/content/early/2018/12/11/5091.full
AB  - Purpose Evaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes.Methods Retrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors.Results A total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m2, 86% female). Cervical deformity rate was 38.5% at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0% and 41.7%, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P > .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P = .025) and 2 years (OR 1.04, P = .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P = .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P = .041). CD development did not significantly impact health-related quality of life (P > .05). Conclusions Cervical deformity can manifest in nonoperative ASD patients: 30.0% at 1-year follow-up, and 41.7% at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.