Evidence map›Paper›PMID 39759223›Full record

ArticleNorth American Spine Society journal2024

A retrospective cohort analysis of alignment parameters for spinal tumor patients with instrumentation at the cervicothoracic junction.

Christian B Schroeder, Madison J Michles, Rahul A Sastry, Alexander A Chernysh, Owen P Leary, Felicia Sun, Joaquin Q Camara-Quintana, Adetokunbo A Oyelese, Albert E Telfeian, Jared S Fridley and 3 more

Abstract read
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Article in North American Spine Society journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Christian B SchroederDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Madison J MichlesDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Rahul A SastryDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Alexander A ChernyshDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Owen P LearyDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Felicia SunDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Joaquin Q Camara-QuintanaDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Adetokunbo A OyeleseDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Albert E TelfeianDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Jared S FridleyDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Ziya L GokaslanDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Patricia Zadnik SullivanDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Tianyi NiuDepartment of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Previous research on spinal alignment and postoperative outcomes after cervical and upper thoracic fixation has suggested that clinical and patient-reported outcomes are improved when certain anatomical parameters are maintained. These parameters include the cervical sagittal vertical axis (cSVA), C2 and T1 slopes, and cervical lordosis (CL). For patients with primary and metastatic tumors involving the subaxial cervical and/or upper thoracic spine, there is minimal guidance on how to apply these parameters. Surgeons must make critical decisions when designing the optimal construct, considering patient life expectancy, bone quality, oncology goals and deformity. This study aims to evaluate the impact of cervical spine alignment parameters on postoperative hardware failure in spine tumor patients and highlight instances of complications in patients with instrumentation crossing the cervicothoracic junction (CTJ). Methods: A retrospective review of a single institutional spine tumor database identified seventeen patients who underwent spinal fusion crossing the CTJ from 2015 to 2023. All patients had postoperative neutral standing radiographs with measurable cSVA, C2 and T1 slopes, and/or CL. The primary endpoint was instrumentation failure, defined as hardware pull out or breakage, and secondary endpoints included other complications including wound infection and spinal fluid leak. Results: The number of instrumented levels ranged from 3 to 15 segments with a mean of 7.47. Surgical approaches included anterior ( Conclusions: Although there was wide variability in alignment parameters in this cohort, there were no instances of hardware failure with crossing the CTJ at a mean follow-up of 41 months. The overall complication rate was high at 24%. Despite common concerns about the impact of exaggerated slope and SVA on instrumentation failure these results suggest that cervical and upper thoracic tumor patients may still have a satisfactory result following CTJ fixation, even with unfavorable alignment parameters. Larger prospective studies are needed.

Indexed as

AlignmentCervical lordosisCervical sagittal vertical axisCervicothoracic junctionSpine tumorT1 slope

Identifiers

PMID39759223
PMCPMC11697274

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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.