ReviewNeurosurgery practice2026
Impact of Cervical Sagittal Alignment Changes on Postoperative C5 Palsy: A Systematic Review and Meta-Analysis.
Review in Neurosurgery practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesPostoperative C5 palsy (CP) is a recognized complication after cervical decompressive surgery for degenerative cervical myelopathy. Although cervical sagittal alignment has been implicated in its pathogenesis, the relative impact of static alignment parameters vs postoperative alignment changes remains unclear. This study aimed to evaluate the association between cervical sagittal alignment and postoperative CP, with emphasis on the magnitude of alignment correction.
methodsA systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Web of Science, Scopus, and Embase were searched from inception to January 2025. Retrospective cohort studies comparing degenerative cervical myelopathy patients with and without postoperative CP and reporting cervical sagittal parameters were included. Outcomes included preoperative values, postoperative values, and magnitude of change (Δ) in C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), C4-C5 segmental lordosis, T1 slope, T1 slope-cervical lordosis mismatch, and Ishihara index. Standardized mean differences (SMDs) with 95% CIs were pooled.
resultsThirty-seven studies comprising 4948 patients were included, with an overall CP incidence of 10.83%. Static preoperative parameters, including C2-C7 lordosis, C2-C7 SVA, T1 slope, and T1 slope-cervical lordosis mismatch, were not significantly associated with CP. By contrast, patients who developed CP demonstrated significantly greater postoperative increases in C2-C7 lordosis (SMD = 1.04), C2-C7 SVA (SMD = 1.38), C4-C5 segmental lordosis (SMD = 0.44), and Ishihara index (SMD = 1.79). Subgroup analyses showed significant associations in anterior procedures and laminectomy, but not in laminoplasty.
conclusionPostoperative CP is primarily driven by the magnitude of sagittal alignment correction rather than baseline alignment. These findings support a stretch-mediated mechanism related to postoperative spinal cord and nerve root biomechanics and highlight the importance of balanced sagittal correction to reduce the risk of CP.
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.