ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Surgical strategies and outcomes in degenerative myelopathy at the cervico-thoracic junction: a multicenter retrospective analysis.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Surgical Outcomes of Craniocervical Junction Fractures in Elderly Patients: A Retrospective Single-Center Series.Journal of personalized medicine · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to investigate the clinical characteristics, treatment strategies, and outcomes of patients with cervico-thoracic junction degenerative myelopathy.
methodsA multicenter retrospective study was conducted, involving 51 adult patients with spondylotic myelopathy crossing the cervico-thoracic junction. Data on demographics, comorbidities, surgical procedures, complications, and short-term outcomes were collected. Univariate and multivariate logistic regression models were used to assess associations with postoperative outcomes, ensuring statistical rigor (e.g., multicollinearity and event-per-variable thresholds). T1-slope values were measured before and after surgery. A change within ± 2° was defined as "stable".
resultsPatients underwent anterior-only (n = 13), posterior-only (n = 25), or combined anterior-posterior (n = 13) approaches. The mean preoperative T1-slope was 24.5° ± 7.6°, and the postoperative T1-slope was 28.2° ± 8.1° (p = 0.04). Posterior-only approaches were associated with greater early increases in T1-slope and higher complication rates. Higher ASA scores (> 2) were significantly correlated with postoperative complications. Surprisingly, general comorbidities were not independently associated with worse outcomes. Multilevel myelopathy involving C7-T1 correlated with more frequent complications and T1-slope changes.
conclusionsSurgical strategy and ASA classification emerged as key factors in short-term outcomes for CTJ myelopathy. While posterior-only approaches showed worse early radiographic and clinical results, causality cannot be inferred due to the retrospective design. Early changes in sagittal alignment (T1-slope) may reflect the quality of postoperative alignment correction, but their long-term clinical significance requires prospective evaluation. Tailored, risk-adapted surgical planning may help optimize outcomes in this complex anatomical region.
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Registered trials
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