Reciprocal Changes Following Cervical Realignment Surgery

Lee, Jae Koo; Hyun, Seung-Jae; Yang, Seung Heon; Kim, Ki-Jeong

doi:10.14245/ns.2249938.469

Cited by 7 publications

(15 citation statements)

References 49 publications

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“…Overall, patients’ postures became more comfortable after surgery [ 31 – 33 ]. The changes of local, regional, and global curvature may be speculated like followings [ 31 , 33 – 35 ]. Patient could extend neck more freely without pain and this may explain improved regional cervical curvature.…”

Section: Discussionmentioning

confidence: 99%

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

et al. 2023

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Objective Posterior full-endoscopic cervical foraminotomy (PECF) is one of minimally invasive surgical techniques for cervical radiculopathy. Because of minimal disruption of posterior cervical structures, such as facet joint, cervical kinematics was minimally changed. However, a larger resection of facet joint is required for cervical foraminal stenosis (FS) than disc herniation (DH). The objective was to compare the cervical kinematics between patients with FS and DH after PECF. Methods Consecutive 52 patients (DH, 34 vs. FS, 18) who underwent PECF for single-level radiculopathy were retrospectively reviewed. Clinical parameters (neck disability index, neck pain and arm pain), and segmental, cervical and global radiological parameters were compared at postoperative 3, 6, and 12 months, and yearly thereafter. A linear mixed-effect model was used to assess interactions between groups and time. Any occurrence of significant pain during follow-up was recorded during a mean follow-up period of 45.5 months (range 24–113 months). Results Clinical parameters improved after PECF, with no significant differences between groups. Recurrent pain occurred in 6 patients and surgery (PECF, anterior discectomy and fusion) was performed in 2 patients. Pain-free survival rate was 91% for DH and 83% for FS, with no significant difference between the groups (P = 0.29). Radiological changes were not different between groups (P > 0.05). Segmental neutral and extension curvature became more lordotic. Cervical curvature became more lordotic on neutral and extension X-rays, and the range of cervical motion increased. The mismatch between T1-slope and cervical curvature decreased. Disc height did not change, but the index level showed degeneration at postoperative 2 years. Conclusion Clinical and radiological outcomes after PECF were not different between DH and FS patients and kinematics were significantly improved. These findings may be informative in a shared decision-making process.

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Section: Discussionmentioning

confidence: 99%

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

et al. 2023

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Section: Global Balance and Compensatory Mechanismmentioning

confidence: 99%

“…Understanding the intricate interplay between compensatory mechanisms and global balance is a pivotal precursor to comprehending the clinical impact of global balance [ 16 , 23 , 25 , 26 ]. As aging and certain pathological conditions manifest, deterioration of the GSA may lead to imbalance [ 16 , 23 , 26 ]. In such scenarios, compensatory mechanisms become pivotal in upholding global balance, ensuring erect posture and facilitating a horizontal gaze [ 23 , 26 , 36 ].…”

Section: Global Balance and Compensatory Mechanismmentioning

confidence: 99%

“…This complexity signifies that while the pursuit of appropriate spinal alignment, encompassing well-aligned global spinal alignment (GSA), is a pivotal facet, its sole consideration might fall short in effectively preventing MF in the context of ASD surgery. Consequently, a more comprehensive spectrum of factors necessitates consideration [15][16][17][18]22,23,26) .…”

Section: Introductionmentioning

confidence: 99%

“…Of particular significance in this landscape is the pivotal role of global balance, which has garnered extensive attention from researchers [ 1 , 32 ]. The centrality of the center of gravity (COG) and the imperative for a holistic evaluation of the entire body have been repeatedly underscored in the literature [ 11 , 23 , 26 , 34 , 36 , 39 ]. Technological advancements, epitomized by innovations like the EOS whole-body imaging system (EOS Imaging, Paris, France), have empowered the comprehensive analysis of the entire body while minimizing radiation exposure and distortion [ 5 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Narrative Review of Clinical Impact of Head-Hip Offset Following Adult Spinal Deformity Surgery

Kim,

Hyun,

Lee

et al. 2024

J Korean Neurosurg Soc

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In adult spinal deformity (ASD) surgery, mechanical failure (MF) has been a significant concern for spine surgeons as well as patients. Despite earnest endeavors to prevent MF, the absence of a definitive consensus persists, owing to the intricate interplay of multifarious factors associated with this complication. Previous approaches centered around global spinal alignment have yielded limited success in entirely forestalling MF. These methodologies, albeit valuable, exhibited limitations by neglecting to encompass global balance and compensatory mechanisms within their purview. In response to this concern, an in-depth comprehension of global balance and compensatory mechanisms emerges as imperative. In this discourse, the center of gravity and the gravity line are gaining attention in recent investigations pertaining to global balance. This narrative review aims to provide an overview of the global balance and a comprehensive understanding of related concepts and knowledge. Moreover, it delves into the clinical ramifications of the contemporary optimal correction paradigm to furnish an encompassing understanding of global balance and the current optimal correction strategies within the context of ASD surgery. By doing so, it endeavors to furnish spine surgeons with a guiding compass, enriching their decision-making process as they navigate the intricate terrain of ASD surgical interventions.

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From the Spinopelvic Parameters to Global Alignment and Proportion Scores in Adult Spinal Deformity

Cho

Hyun

et al. 2023

Neurospine

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In the last 20 years, sagittal alignment and balance of the spine have become one of the most important issues in the field of spine surgery. Recent studies emphasize that sagittal balance and alignment are more important for health-related quality of life. The understanding of normal and abnormal sagittal alignment of the spine is necessary for the diagnosis and appropriate treatment of adult spinal deformity (ASD), and we will discuss the currently used classification of ASD, the parameters of sagittal alignment that are essential for the diagnosis of spinal deformity, compensatory actions to maintain sagittal balance, and the relationship between sagittal alignment and clinical symptoms. Furthermore, we will also discuss the recently introduced Global Alignment and Proportion scores. The Korean Spinal Deformity Society is publishing a series of review articles on spinal deformities to help spine surgeons better understand spinal deformities.

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Reciprocal Changes Following Cervical Realignment Surgery

Cited by 7 publications

References 49 publications

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

Narrative Review of Clinical Impact of Head-Hip Offset Following Adult Spinal Deformity Surgery

From the Spinopelvic Parameters to Global Alignment and Proportion Scores in Adult Spinal Deformity

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