{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:57:14Z","timestamp":1786125434582,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Posterior cervical fusion (PCF) is performed to treat cervical myelopathy, radiculopathy, and\/or deformity. Constructs ending at the cervicothoracic junction (CTJ) may lead to higher rates of adjacent segment disease, and much debate exists regarding crossing the CTJ due to paucity of data in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine whether extension of PCF constructs across the CTJ decreases incidence of adjacent segment disease and need for revision surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A single-center retrospective case series of patients undergoing multilevel PCFs since 2011 with at least 6-mo follow-up was conducted. Outcomes were analyzed and compared based on caudal extent of instrumentation via multivariate regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 149 patients underwent PCF, with a mean follow-up of 18.9 mo. A total of 15 (10.1%) revisions were performed, 7 (4.7%) of which were related to the construct. Five (8.3%) revisions were performed for constructs ending at C6, 1 (5.3%) at C7, 1 (2.6%) at T1, and none (0%) at T2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.035). Mean procedure duration was 215\u00a0min at C6, 214\u00a0min at C7, 239\u00a0min at T1, and 343\u00a0min at T2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.001). Mean estimated blood loss was 224\u00a0mL at C6, 178\u00a0mL at C7, 308\u00a0mL at T1, and 575\u00a0mL at T2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.001). There was no difference in length of stay, disposition, surgical site infection, or radiographic parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Extension of PCFs across the CTJ leads to lower early revision rates, but also to increased procedure duration and estimated blood loss. As such, decisions regarding caudal extent of instrumentation must weigh the risk of pseudarthrosis against that of longer procedures with higher blood loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa078","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T08:28:14Z","timestamp":1582878494000},"page":"E544-E550","source":"Crossref","is-referenced-by-count":29,"title":["Crossing the Cervicothoracic Junction During Posterior Cervical Decompression and Fusion: Is It Necessary?"],"prefix":"10.1227","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4183-4744","authenticated-orcid":false,"given":"Islam","family":"Fayed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T","family":"Toscano","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Triano","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erini","family":"Makariou","sequence":"additional","affiliation":[{"name":"Department of Radiology, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christabel","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M","family":"Spitz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad N","family":"Anaizi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Nathan","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheem A","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1330-5850","authenticated-orcid":false,"given":"Jean-Marc","family":"Voyadzis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"22 Suppl","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"S52","DOI":"10.1097\/BRS.0b013e31826d60fb","article-title":"Predicting the risk of adjacent segment pathology in the cervical spine","volume":"37","author":"Lawrence","year":"2012","journal-title":"Spine"},{"key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"e408","DOI":"10.1016\/j.wneu.2018.10.062","article-title":"Complications of poor cervical alignment in patients undergoing posterior cervicothoracic laminectomy and fusion","volume":"122","author":"Kennamer","year":"2019","journal-title":"World Neurosurg"},{"key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.wneu.2017.04.029","article-title":"Posterior multilevel instrumentation of the lower cervical spine: is bridging the cervicothoracic junction necessary","volume":"103","author":"Osterhoff","year":"2017","journal-title":"World Neurosurg"},{"issue":"23","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1097\/BRS.0000000000001864","article-title":"Is it necessary to extend a multilevel posterior cervical decompression and fusion to the upper thoracic spine","volume":"41","author":"Schroeder","year":"2016","journal-title":"Spine"},{"issue":"5","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.spinee.2017.09.010","article-title":"Should long-segment cervical fusions be routinely carried into the thoracic spine? 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