RT Journal Article
SR Electronic
T1 Development of New-Onset Cervical Deformity in Nonoperative Adult Spinal Deformity Patients With 2-Year Follow-Up
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 5091
DO 10.14444/5091
A1 Passias, Peter G.
A1 Jalai, Cyrus M.
A1 Worley, Nancy
A1 Vira, Shaleen
A1 Scheer, Justin K.
A1 Smith, Justin S.
A1 Ramachandran, Subaraman
A1 Soroceanu, Alexandra
A1 Horn, Samantha R.
A1 Poorman, Gregory W.
A1 Protopsaltis, Themistocles S.
A1 Klineberg, Eric O.
A1 Sciubba, Daniel M.
A1 Kim, Han Jo
A1 Hamilton, D. Kojo
A1 Lafage, Renaud
A1 Lafage, Virginie
A1 Ames, Christopher P.
A1 International Spine Study Group (ISSG)
YR 2018
UL https://www.ijssurgery.com/content/early/2018/12/11/5091.abstract
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.