ArticleInternational journal of spine surgery2026
Cervical Sagittal Alignment and Patient-Reported Outcomes in Posterior Cervical Fusion: A Longitudinal Comparative Cohort Study.
Article in International journal of spine surgery, 2026. 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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Abstract
backgroundThe impact of cervical sagittal parameters on patient-reported outcomes (PRO) after posterior cervical fusion (PCF) remains inconclusive. We sought to evaluate whether normative sagittal cervical alignment was independently associated with improved PRO.
methodsRetrospective review of consecutive patients who underwent PCF for degenerative conditions from January 2016 to December 2020 at a single institution with multiple surgeons. Cervical sagittal vertical axis (cSVA), McGregor's slope (McGS), and T1 slope minus C2-7 lordosis (T1S-CL) were measured using standing neutral lateral radiographs at preoperative and 1 year postoperatively. Normative parameters were defined as cSVA ≤4 cm, -5° ≤ McGS ≤ 15°, and T1S-CL < 20°. The primary outcome was the minimum clinically important difference (MCID) among validated PRO (12-item Short Form Mental and Physical Component Summaries, Neck Disability Index, neck and arm numeric rating scale, and modified Japanese Orthopaedic Association scale) collected prospectively preoperatively, 6 months, and 1 year postoperatively. Univariate analysis was used to compare demographics, operative characteristics, and proportions achieving MCID between parameter groups. Multiple logistic regression models were used to adjust for confounders. Radiographic parameters were included as the predictor.
resultsOne hundred and four patients (54 men and 50 women with a mean age of 61.8 ± 10.6 years), were included. Operative levels ranged from C2 to T3, with 4 to 8 operative levels. Normative cSVA patients were younger (59.4 vs 67.5 years,
conclusionIn this retrospective cohort study of patients undergoing multi-level PCF, achievement of MCID in PRO was comparable between patients with normative and non-normative postoperative cervical sagittal alignment. CLINICAL RELEVANCE: Normative cervical cSVA, McGS, or T1S-CL following PCF surgery is not independently associated with improvement in PRO. LEVEL OF EVIDENCE: 3:
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