Evidence map›Paper›PMID 29396766›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018

Analysis of cervical sagittal alignment variations after lumbar pedicle subtraction osteotomy for severe imbalance: study of 59 cases.

W Thompson, A Cogniet, M Challali, R Saddiki, J Rigal, Jean Charles Le Huec

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

W ThompsonSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France.
A CognietSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France.
M ChallaliSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France.
R SaddikiSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France.
J RigalSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France.
Jean Charles Le HuecSurgical Research Lab, Orthospine Department, Bordeaux University Hospital, CHU Pellegrin, Orthorachis 2, 33076, Bordeaux, France. j-c.lehuec@u-bordeaux.fr.
Hôpital Pellegrin · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate postoperative changes within the cervical alignment following surgical lumbar correction by pedicle subtraction osteotomy (PSO) in patients affected with sagittal global malalignment disease.

methodsThis was a monocentric, radiographic, and prospective study. 79 patients, who underwent sagittal correction by PSO, performed an EOS imaging pre- and postoperatively between January 2008 and December 2013 at the University Hospital of Bordeaux. Inclusion criteria were a performed pre- and postoperative EOS imaging and a preoperative C7SVA > 5 cm. Were excluded patients who did not allow EOS with a viewable cervical spine due to hyperkyphosis. The study involved the analysis of pelvic, lumbar, thoracic, cervical, and cranial parameters before and after the surgery.

results59 patients met the criteria. Mean follow-up was 38 months. The lumbar PSO significantly improved sagittal alignment including L1S1 lordosis, T1T12 kyphosis, and C7SVA (p < 0.001). We did not reported a significant change within cervical parameters after PSO (C2C7 lordosis 22.7°-21.5° p = 0.64, C1C7 lordosis 50.6°-48.8° p = 0.56, C1C2 angle 28.2°-27.9° p = 0.82, C7 slope stayed constant 32.3°-30.5° p = 0.47, OC2 angle 15.54°-15.56° p = 0.99). However, cranial slope decreased significantly (p < 0.05). We did not find correlation between lumbar lordosis and cervical lordosis variations (R = 0.265). Cervical lordosis was highly correlated with the C7 slope (R = 0.597) and with the Spino Cranial Angle (R = - 0.867).

conclusionReciprocal changes in cervical spine after PSO are difficult to approach. Maintaining a horizontal gaze involves locoregional mechanisms of compensation adapting to the slope of C7. The cranial system by decreasing the cranial slope allows the gaze alignment and is the first compensation mechanism to get involved after a loss of lumbar lordosis. Restoring optimal C7SVA is necessary to prevent the development of secondary cervical painful symptomatology when the cranial compensation is outdated.

Indexed as

OsteotomyFollow-Up StudiesHumansKyphosisLordosisPostureSpineTreatment OutcomeCervical sagittal balanceCervical spine alignmentLumbar osteotomyOD-HA (odontoid-hip axis angle)PSO consequencesPSO (posterior subtraction osteotomy)

Identifiers

PMID29396766
OpenAlexW2786216451

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.