{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:20:50Z","timestamp":1791411650301,"version":"4.3.3"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Adult cervical deformity (ACD) classifications have not been implemented in a prospective ACD population and in conjunction with adult spinal deformity (ASD) classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To characterize cervical deformity type and malalignment with 2 classifications (Ames-ACD and Schwab-ASD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Retrospective review of a prospective multicenter ACD database. Inclusion: patients \u226518 yr with pre- and postoperative radiographs. Patients were classified with Ames-ACD and Schwab-ASD schemes. Ames-ACD descriptors (C = cervical, CT = cervicothoracic, T = thoracic, S = coronal, CVJ = craniovertebral) and alignment modifiers (cervical sagittal vertical axis [cSVA], T1 slope minus cervical lordosis [TS-CL], modified Japanese Ortphopaedic Association [mJOA] score, horizontal gaze) were assigned. Schwab-ASD curve type stratification and modifier grades were also designated. Deformity and alignment group distributions were compared with Pearson \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \/ANOVA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Ames-ACD descriptors in 84 patients: C = 49 (58.3%), CT = 20 (23.8%), T = 9 (10.7%), S = 6 (7.1%). cSVA modifier grades differed in C, CT, and T deformities (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .019). In C, TS-CL grade prevalence differed (\n                      <jats:italic toggle=\"yes\">P =<\/jats:italic>\n                      .031). Among Ames-ACD modifiers, high (1+2) cSVA grades differed across deformities (C = 47.7%, CT = 89.5%, T = 77.8%, S = 50.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .013). Schwab-ASD curve type and presence (n = 74, T = 2, L = 6, D = 2) differed significantly in S deformities (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Higher Schwab-ASD pelvic incidence minus lumbar lordosis grades were less likely in Ames-ACD CT deformities (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .027). Higher pelvic tilt grades were greater in high (1+2) cSVA (71.4% vs 36.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .015) and high (2+3) mJOA (24.0% vs 38.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .021) scores. Postoperatively, C and CT deformities had a trend toward lower cSVA grades, but only C deformities differed in TS-CL grade prevalence (0 = 31.3%, 1 = 12.2%, 2 = 56.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Cervical deformities displayed higher TS-CL grades and different cSVA grade distributions. Preoperative associations with global alignment modifiers and Ames-ACD descriptors were observed, though only cervical modifiers showed postoperative differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyx175","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:09:47Z","timestamp":1489536587000},"page":"192-201","source":"Crossref","is-referenced-by-count":21,"title":["Characterizing Adult Cervical Deformity and Disability Based on Existing Cervical and Adult Deformity Classification Schemes at Presentation and Following Correction"],"prefix":"10.1227","volume":"82","author":[{"given":"Peter G","family":"Passias","sequence":"first","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus M","family":"Jalai","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel G","family":"Diebo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Poorman","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subaraman","family":"Ramchandran","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the International Spine Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,2]]},"reference":[{"issue":"22 suppl 1","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"S147","DOI":"10.1097\/BRS.0b013e3182a7f521","article-title":"Myelopathy and spinal deformity: relevance of spinal alignment in planning surgical intervention for degenerative cervical myelopathy","volume":"38","author":"Shamji","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"5","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1227\/NEU.0b013e31820b51f3","article-title":"Prospective randomized double blinded clinical study evaluating the correlation of clinical outcomes and cervical sagittal alignment","volume":"68","author":"Villavicencio","year":"2011","journal-title":"Neurosurgery"},{"issue":"21","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1097\/00007632-200111010-00011","article-title":"Multisurgeon assessment of surgical decision-making in adolescent idiopathic scoliosis: curve classification, operative approach, and fusion levels","volume":"26","author":"Lenke","year":"2001","journal-title":"Spine (Phila Pa 1976)"},{"issue":"12","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/BRS.0b013e31823e15e2","article-title":"Scoliosis Research Society\u2014schwab adult spinal deformity classification","volume":"37","author":"Schwab","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"bib5-20231011","doi-asserted-by":"crossref","DOI":"10.3171\/2014.12.SPINE14780","article-title":"Reliability assessment of a novel cervical spine deformity classification system","author":"Ames","year":"2015","journal-title":"J Neurosurg Spine"},{"issue":"22 suppl 1","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1097\/BRS.0b013e3182a7f449","article-title":"Cervical radiographic alignment: comprehensive assessment techniques and potential importance in cervical myelopathy","volume":"38","author":"Ames","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.nec.2012.12.010","article-title":"Assessment and treatment of cervical deformity","volume":"24","author":"Scheer","year":"2013","journal-title":"Neurosurg Clin N Am"},{"issue":"3","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1227\/NEU.0b013e31826100c9","article-title":"The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery","volume":"71","author":"Tang","year":"2012","journal-title":"Neurosurgery"},{"issue":"22 suppl 1","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"S161","DOI":"10.1097\/BRS.0b013e3182a7eb9e","article-title":"Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study","volume":"38","author":"Smith","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1227\/NEU.0000000000000012","article-title":"The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort","volume":"73","author":"Terran","year":"2013","journal-title":"Neurosurgery"},{"issue":"9","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.spinee.2012.08.172","article-title":"Change in classification grade by the schwab-srs adult spinal deformity classification and impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment","volume":"12","author":"Smith","year":"2012","journal-title":"Spine J"},{"issue":"11","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1097\/BRS.0b013e318280c478","article-title":"Validation and reliability analysis of the new SRS-Schwab classification for adult spinal deformity","volume":"38","author":"Liu","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"19","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1097\/BRS.0b013e31829ec563","article-title":"Change in classification grade by the SRS-Schwab Adult Spinal Deformity Classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment","volume":"38","author":"Smith","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"17","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/BRS.0000000000000432","article-title":"Prevalence and type of cervical deformity among 470 adults with throacolumbar deformity","volume":"39","author":"Smith","year":"2014","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.nec.2012.12.009","article-title":"Clinical and radiographic evaluation of the adult spinal deformity patient","volume":"24","author":"Smith","year":"2013","journal-title":"Neurosurg Clin N Am"},{"issue":"5","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/BRS.0000000000000746","article-title":"Postoperative cervical deformity in 215 thoracolumbar patients with adult spinal deformity: prevalence, risk factors, and impact on patient-reported outcome and satisfaction at 2-year follow-up","volume":"40","author":"Passias","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1007\/s00586-005-0927-1","article-title":"Validation of new clinical quantitative analysis software applicable in spine orthopaedic studies","volume":"15","author":"Champain","year":"2006","journal-title":"Eur Spine J"},{"issue":"3","key":"bib18-20231011","first-page":"218","article-title":"Validation of a tool to measure pelvic and spinal parameters of sagittal balance","volume":"89","author":"Rillardon","year":"2003","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"2","key":"bib19-20231011","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3171\/2013.4.SPINE12838","article-title":"Cervical spine alignment, sagittal deformity, and clinical implications","volume":"19","author":"Scheer","year":"2013","journal-title":"J Neurosurg Spine"},{"issue":"2","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3171\/2014.11.SPINE1441","article-title":"How the neck affects the back: changes in regional cervical sagittal alignment correlate to HRQOL improvement in adult thoracolumbar deformity patients at 2-year follow-up","volume":"23","author":"Protopsaltis","year":"2015","journal-title":"J Neurosurg Spine"},{"issue":"12","key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/BRS.0b013e31823e15e2","article-title":"Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study","volume":"37","author":"Schwab","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"issue":"8","key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1016\/j.spinee.2015.04.007","article-title":"Magnitude of preoperative cervical lordotic compensation and c2-t3 angle are correlated to increased risk of post-operative sagittal spinal pelvic malalignment in adult thoracolumbar deformity patients at 2-year follow-up","volume":"15","author":"Passias","year":"2015","journal-title":"Spine J"},{"issue":"8","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1097\/BSD.0000000000000119","article-title":"The Increased Prevalence of Cervical Spondylosis in Patients with Adult Thoracolumbar Spinal Deformity","volume":"27","author":"Schairer","year":"2014","journal-title":"J Spinal Disord Tech"},{"issue":"22 suppl 1","key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1097\/BRS.0b013e3182a7f449","article-title":"Cervical radiographical alignment: comprehensive assessment techniques and potential importance in cervical myelopathy","volume":"38","author":"Ames","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"18","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The impact of positive sagittal balance in adult spinal deformity","volume":"30","author":"Glassman","year":"2005","journal-title":"Spine (Phila Pa 1976)"},{"issue":"13","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"E803","DOI":"10.1097\/BRS.0b013e318292b7b9","article-title":"Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis","volume":"38","author":"Schwab","year":"2013","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/82\/2\/192\/32599754\/nyx175.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/00006123-201802000-00011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:27Z","timestamp":1786121367000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201802000-00011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,30]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyx175","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,30]]}}}