The odontoid-CSVL distance in a global population of asymptomatic volunteers: normative values and implications for spinal coronal alignment

Zuckerman, Scott L.; Sardar, Zeeshan M.; Lai, Christopher; Marciano, Gerard; Kerolus, Mena G.; Buchanan, Ian A.; Ha, Alex; Cerpa, Meghan; Kelly, Michael P.; Bourret, Stéphane; Hara, Kazuhiro; Wong, Hee‐Kit; Liu, Gabriel; Hey, Hwee Weng Dennis; Riahi, Hend; Huec, Jean-Charles Le; Lenke, Lawrence G.

doi:10.1007/s00586-021-06873-6

Cited by 5 publications

(17 citation statements)

References 30 publications

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“…Als Weiterentwicklung der koronaren Balance kann das C7-Lot durch ein Lot ausgehend von der Densspitze (OD) nach unten ersetzt werden, sodass auch die HWS in der koronaren Balance (OD-cSVL) berücksichtigt wird [12].…”

Section: Koronare Balanceunclassified

Bildgebung der Wirbelsäule

Butscher,

Langheinirch,

Kandziora

2023

Orthopädie und Unfallchirurgie up2date

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Section: Koronare Balanceunclassified

Bildgebung der Wirbelsäule

Butscher,

Langheinirch,

Kandziora

2023

Orthopädie und Unfallchirurgie up2date

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“…The details of the MEANS cohort composition can be found in previously published literature. 16 A retrospective query was conducted at a single institution using prospectively collected data from two spinal deformity surgeons to assemble the symptomatic cohort. The cohort's composition details could be found in previous literature.…”

Section: Methodsmentioning

confidence: 99%

“…The OD-CVA correlated with known coronal measurements, including the C7-CVA in an asymptomatic volunteer cohort. 16 Cranial coronal parameters appear to gauge CM well.…”

mentioning

confidence: 99%

“…It correlated with known coronal measurements and patient-reported outcomes (PROs) and was associated with increased odds of complication. 8 Zuckerman et al 16 also proposed the odontoid coronal vertical axis (OD-CVA), the distance between the central sacral vertical line and the vertical line from the odontoid tip. The OD-CVA correlated with known coronal measurements, including the C7-CVA in an asymptomatic volunteer cohort.…”

mentioning

confidence: 99%

“…Previous literature demonstrates that the OD-CVA correlates with known radiographic parameters in an asymptomatic cohort and the ORB-CVA with radiographic parameters in a symptomatic ASD cohort. 8,16 However, OD-CVA and ORB-CVA could be difficult to measure in patients with spinal pathology. Whether alternative cranial coronal parameters could correlate with radiographic parameters and outcomes is unknown.…”

mentioning

confidence: 99%

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Practical Methods of Assessing Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery

Shen,

Sardar,

Greisberg

et al. 2023

Spine

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Study Design. Asymptomatic cohort: prospective, cross-sectional, multi-center. Symptomatic: retrospective, multi-surgeon, single-center. Objective. To assess the association between cranial coronal alignment and adult spinal deformity (ASD) surgical risk and outcomes. Summary of Background Data. ASD leads to decreased quality of life. Studies have shown that coronal malignment (CM) is associated with worse surgical outcomes. Methods. 468 adult participants were prospectively enrolled in the asymptomatic cohort. 172 symptomatic ASD patients with 2-year follow-ups were retrospectively enrolled in the symptomatic cohort. Three cranial plumb line parameters: the positions of the plumb lines from the midpoint between the medial orbital rims (ORB-L5), the odontoid (OD-L5), and the C7 centroid (C7-L5) relative to the L5 pedicle, were measured. Each subject had plumb line medial (M), touching (T), or lateral (L) to either pedicle. The association between each group of patients and radiographic parameters, intraoperative variables, patient-reported outcomes (PROs), and clinical outcomes were analyzed. Results. In the asymptomatic cohort, OD-L5 was medial to or touching the L5 pedicle in 98.3% of volunteers. In the symptomatic patients, preoperative OD-L5-L exhibited higher mean age (56.2±14.0), odontoid-coronal vertical axis (OD-CVA) (5.5±3.3 cm), Oswestry Disability Index (ODI) score (40.6±18.4), pelvic fixation rate (56/62, 90.3%), OR time (528.4±144.6 min), median estimated blood loss (EBL) (1300cc), and durotomy rate (24/62, 38.7%). A similar pattern of higher CVA, preoperative ODI, intraoperative pelvic fixation rate, OR time, EBL, and durotomy rate was observed in ORB-L5-L and C7-L5-L patients. Final follow-up postoperative OD-L5-L was associated with higher rates of proximal junctional kyphosis (PJK) (13.0%) and pseudarthrosis (17.4%). Conclusion. Preoperative OD-L5, ORB-L5, and C7-L5 lateral to pedicles were associated with worse preoperative ODI and higher intraoperative complexity. Postoperative OD-L5-L was associated with higher rates of PJK and pseudarthrosis. Postoperative CM, approximated by cranial plumb line lateral to the L5 pedicles, was associated with sagittal plane complications.

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