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Osteotomies in the Cervical Spine.

Nemani VM, Derman PB, Kim HJ - Asian Spine J (2016)

Bottom Line: In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance.In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment.We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO, USA.

ABSTRACT
Rigid cervical deformities are difficult problems to treat. The goals of surgical treatment include deformity correction, achieving a rigid fusion, and performing a thorough neural decompression. In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance. In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment. We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications.

No MeSH data available.


Related in: MedlinePlus

Lateral EOS image of the cervical spine showing the measurement of C2–C7 sagittal vertical axis (C2–C7 SVA).
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Figure 3: Lateral EOS image of the cervical spine showing the measurement of C2–C7 sagittal vertical axis (C2–C7 SVA).

Mentions: A complete description of the sagittal profile of the cervical spine depends on both an angular measure as well as a translational measure of the position of the upper cervical spine with respect to C7. The cervical sagittal vertical axis (SVA) is such a measure of spinal translation, and is necessary to more completely define the deformity. C2–C7 SVA is defined as the horizontal distance between the posterior superior aspect of the C7 vertebral body and a plumb line dropped from the center of the C2 vertebral body (Fig. 3). Positive values indicate that the center of C2 body lies anterior to the posterior superior aspect of the C7 body. The normal cervical SVA in asymptomatic individuals has been quantified at 15.6±11.2 mm, and increasing values (especially those ≥40 mm) have been shown to negatively impact HRQoL in patients who have undergone posterior cervical fusion surgery [2435]. While lordosis may affect cervical SVA, note that patients with identical cervical Cobb angles may have large differences in their C2–C7 SVA depending on alignment at the cervicothoracic junction.


Osteotomies in the Cervical Spine.

Nemani VM, Derman PB, Kim HJ - Asian Spine J (2016)

Lateral EOS image of the cervical spine showing the measurement of C2–C7 sagittal vertical axis (C2–C7 SVA).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764533&req=5

Figure 3: Lateral EOS image of the cervical spine showing the measurement of C2–C7 sagittal vertical axis (C2–C7 SVA).
Mentions: A complete description of the sagittal profile of the cervical spine depends on both an angular measure as well as a translational measure of the position of the upper cervical spine with respect to C7. The cervical sagittal vertical axis (SVA) is such a measure of spinal translation, and is necessary to more completely define the deformity. C2–C7 SVA is defined as the horizontal distance between the posterior superior aspect of the C7 vertebral body and a plumb line dropped from the center of the C2 vertebral body (Fig. 3). Positive values indicate that the center of C2 body lies anterior to the posterior superior aspect of the C7 body. The normal cervical SVA in asymptomatic individuals has been quantified at 15.6±11.2 mm, and increasing values (especially those ≥40 mm) have been shown to negatively impact HRQoL in patients who have undergone posterior cervical fusion surgery [2435]. While lordosis may affect cervical SVA, note that patients with identical cervical Cobb angles may have large differences in their C2–C7 SVA depending on alignment at the cervicothoracic junction.

Bottom Line: In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance.In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment.We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO, USA.

ABSTRACT
Rigid cervical deformities are difficult problems to treat. The goals of surgical treatment include deformity correction, achieving a rigid fusion, and performing a thorough neural decompression. In stiff and ankylosed cervical spines, osteotomies are required to restore sagittal and coronal balance. In this chapter, we describe the clinical and radiographic workup for patients with cervical deformities, and delineate the various factors that must be considered when planning surgical treatment. We also describe in detail the various types of cervical osteotomies, along with their surgical technique, advantages, and potential complications.

No MeSH data available.


Related in: MedlinePlus