Evidence map›Paper›PMID 42389303›Full record

ArticleJournal of craniovertebral junction & spine

Does stopping at C2 matter? A comparative analysis of alignment and craniocervical compensation in C2-T1 versus C3-T1 posterior cervical fusion.

Dana Saleh, Ahmad Zayd Alkadri, John S Lingam, Daven Mejica, Diego Soto Rubio, Joshua Vignolles-Jeong, Sawyer Bauer, Katherine Baker, Mohsen Rostami, Patrick Kim and 1 more

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In one paragraph

Article in Journal of craniovertebral junction & spine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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

11 authors.

Dana SalehDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Ahmad Zayd AlkadriDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
John S LingamDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Daven MejicaDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Diego Soto RubioDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Joshua Vignolles-JeongDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Sawyer BauerDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Katherine BakerDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Mohsen RostamiDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Patrick KimDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Puya AlikhaniDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Selection of the proximal upper instrumented vertebra (UIV) in multilevel posterior cervical fusion (PCF) remains controversial. This study compared sagittal alignment, craniocervical compensatory behavior, and perioperative outcomes between C2-T1 and C3-T1 PCF constructs. Methods: A retrospective cohort study was performed, including 79 adult patients who underwent PCF from either C2-T1 ( Results: Baseline demographics and preoperative radiographic parameters were similar between groups. The C3-T1 group demonstrated significantly shorter operative time (198 ± 41 vs. 273 ± 45 min, P < 0.001) and a lower incidence of C5 palsy (5.3% vs. 19.5%, Conclusion: C2-T1 PCF provides superior global sagittal alignment and shifts compensatory demands to the occipitocervical junction, whereas C3-T1 constructs rely more heavily on compensation at the c2-3 level, particularly in patients with higher T1 slope. While C3-T1 fixation reduces operative morbidity, UIV selection should be individualized, incorporating preoperative sagittal parameters to optimize long-term biomechanical outcomes. Clinical Relevance: The findings highlight the importance of individualized surgical planning in multilevel PCF, demonstrating that preoperative sagittal parameters should be incorporated to optimize the selection of the proximal UIV at C2 versus C3, balancing reduced operative morbidity with superior long-term sagittal alignment restoration. Level of Evidence: III.

Indexed as

C2 Slopecervical compensationposterior cervical fusionsagittal alignmentupper instrumented vertebra

Identifiers

PMID42389303
PMCPMC13322731

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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.