{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:12:39Z","timestamp":1792977159316,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2015,3,27]],"date-time":"2015-03-27T00:00:00Z","timestamp":1427414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective radiographic study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We have performed occipitothoracic (OT) fusion for severe rheumatoid cervical disorders since 1991. In our previous study, we reported that the distal junctional disease occurred in patients with fusion of O\u2013T4 or longer due to increased mechanical stress. The present study further evaluated the association between the distal junctional disease and the cervical spine sagittal alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 60 consecutive OT fusion cases between 1991 and 2010, 24 patients who underwent O\u2013T5 fusion were enrolled in this study. The patients were grouped based on whether they developed postoperative distal junctional disease (group F) or not (group N). We measured pre- and postoperative O\u2013C2, C2\u2013C7, and O\u2013C7 angles and evaluated the association between these values and the occurrence of distal junctional disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven (29%) of 24 patients developed adjacent-level vertebral fractures as distal junctional disease. In group F, the mean pre- and postoperative O\u2013C2, C2\u2013C7, and O\u2013C7 angles were 12.1 and 16.8, 7.2 and 11.2, and 19.4 and 27.9 degrees, respectively. In group N, the mean pre- and postoperative O\u2013C2, C2\u2013C7, and O\u2013C7 angles were 15.9 and 15.0, 4.9 and 5.8, and 21.0 and 20.9 degrees, respectively. There were no significant differences between the two groups. The difference in the O\u2013C7 angle (postoperative angle\u2009\u2212\u2009preoperative angle) in group F was significantly larger than that in group N ( p\u2009=\u20090.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Excessive correction of the O\u2013C7 angle (hyperlordotic alignment) is likely to cause postoperative distal junctional disease following the OT fusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1055\/s-0035-1549032","type":"journal-article","created":{"date-parts":[[2015,3,28]],"date-time":"2015-03-28T23:41:14Z","timestamp":1427586074000},"page":"372-377","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Distal Junctional Disease after Occipitothoracic Fusion for Rheumatoid Cervical Disorders: Correlation with Cervical Spine Sagittal Alignment"],"prefix":"10.1177","volume":"5","author":[{"given":"Tetsu","family":"Tanouchi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takachika","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Fueki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatake","family":"Ino","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naofumi","family":"Toda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nodoka","family":"Manabe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gunma Spine Center (Harunaso Hospital), Takasaki, Gunma, 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