Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
The association of cervical sagittal alignment with adjacent segment degeneration.
Trial report 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, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Cervical disc replacement versus anterior cervical discectomy and fusion using stand-alone cage for degenerative cervical spondylosis: a systematic review and meta-analysis based on randomized controlled trials.Neurosurgical review · 2025Pooled it
- A meta-analysis comparing the short- and mid- to long-term outcomes of artificial cervical disc replacement(ACDR) with anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease.International orthopaedics · 2022Pooled it
- [Correlation analysis between preoperative CZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Prevalence and Risk Factors for Cervical Adjacent Segment Disease and Analysis of the Clinical Effect of Revision Surgery: A Minimum of 5 Years' Follow-Up.Global spine journal · 2025Article
- Correlation analysis between preoperative odontoid incidence and clinical outcomes 2 years after anterior cervical discectomy and fusion.Journal of orthopaedic surgery and research · 2025Article
- Zero-profile implant system versus novel plate systems after ACDF for comparison of sagittal balance parameters and clinical efficacy analysis.Journal of orthopaedic surgery and research · 2024Article
- Association of Craniocervical Sagittal Alignment With the Outcomes of Cervical Disc Replacement.Global spine journal · 2024Article
- C4 constant vertebra: a novel benchmark of physiological cervical sagittal alignment.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 · 2024Article
- A novel classification that defines the normal cervical spine: an analysis based on 632 asymptomatic Chinese volunteers.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 · 2024Article
- Emerging Technologies within Spine Surgery.Life (Basel, Switzerland) · 2023Review
- Artificial Intelligence in Neurosurgery: A State-of-the-Art Review from Past to Future.Diagnostics (Basel, Switzerland) · 2023Review
- Adjacent segment mobility after ACDF considering fusion status at the implant insertion site.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 · 2023Article
- Anterior and Posterior Approaches for 4-Level Degenerative Cervical Myelopathy: Low-Profile Cage Versus Cervical Pedicle Screws Fixation.Journal of clinical medicine · 2023Article
- Biomechanics of a novel artificial cervical vertebra from an in vivo caprine cervical spine non-fusion model.Journal of orthopaedic translation · 2022Article
- Clinical and Radiological Outcome in a Series of Patients Treated by Anterior Cervical Discectomy and Fusion: Retrospective Controlled Study With 2 Different Stand-Alone Cages.International journal of spine surgery · 2022Article
- Fatty infiltration in cervical extensor muscle: is there a relationship with cervical sagittal alignment after anterior cervical discectomy and fusion?BMC musculoskeletal disorders · 2022Article
- Cervical Alignment of Patients with Basilar Invagination: A Radiological Study.Orthopaedic surgery · 2022Article
- Comparison of Radiographic Reconstruction and Clinical Improvement between Artificial Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion.Pain research & management · 2022Article
- Commentary on "Impact of Nonlordotic Sagittal Alignment on Short-term Outcomes of Cervical Disc Replacement".Neurospine · 2021Article
- Reply to Commentary on "Impact of Nonlordotic Sagittal Alignment on Short-term Outcomes of Cervical Disc Replacement".Neurospine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
purposeCervical spine surgery may affect sagittal alignment parameters and induce accelerated degeneration of the cervical spine. Cervical sagittal alignment parameters of surgical patients will be correlated with radiological adjacent segment degeneration (ASD) and with clinical outcome parameters.
methodsPatients were analysed from two randomized, double-blinded trials comparing anterior cervical discectomy with arthroplasty (ACDA), with intervertebral cage (ACDF) and without intervertebral cage (ACD). C2-C7 lordosis, T1 slope, C2-C7 sagittal vertical axis (SVA) and the occipito-cervical angle (OCI) were determined as cervical sagittal alignment parameters. Radiological ASD was scored by the combination of decrease in disc height and anterior osteophyte formation. Neck disability index (NDI), SF-36 PCS and MCS were evaluated as clinical outcomes.
resultsThe cervical sagittal alignment parameters were comparable between the three treatment groups, both at baseline and at 2-year follow-up. Irrespective of surgical method, C2-C7 lordosis was found to increase from 11° to 13°, but the other parameters remained stable during follow-up. Only the OCI was demonstrated to be associated with the presence and positive progression of radiological ASD, both at baseline and at 2-year follow-up. NDI, SF-36 PCS and MCS were demonstrated not to be correlated with cervical sagittal alignment. Likewise, a correlation with the value or change of the OCI was absent.
conclusionOCI, an important factor to maintain horizontal gaze, was demonstrated to be associated with radiological ASD, suggesting that the occipito-cervical angle influences accelerated cervical degeneration. Since OCI did not change after surgery, degeneration of the cervical spine may be predicted by the value of OCI. NECK TRIAL: Dutch Trial Register Number NTR1289. PROCON TRIAL: Trial Register Number ISRCTN41681847. These slides can be retrieved under Electronic Supplementary Material.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.