{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:26Z","timestamp":1786125086954,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Previous studies have evaluated cervical kyphosis (C-kypho) using cervical curvature or chin-brow vertical angle, but the relationship between C-kypho and global spinal alignment is currently unknown.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To elucidate global spinal alignment and compensatory mechanisms in primary symptomatic C-kypho using full-spine radiography.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n In this retrospective multicenter study, symptomatic primary C-kypho patients (Cerv group; n = 103) and adult thoracolumbar deformity patients (TL group; n = 119) were compared. We subanalyzed Cerv subgroups according to sagittal vertical axis (SVA) values of C7 (SVA\n C7<\/jats:bold>\n positive or negative [C7P or C7N]). Various Cobb angles (\u00b0) and SVAs (mm) were evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n SVA\n C7<\/jats:bold>\n values were \u201320.2 and 63.6 mm in the Cerv group and TL group, respectively (\n P<\/jats:italic>\n < .0001). Various statistically significant compensatory curvatures were observed in the Cerv group, namely larger lumbar lordosis (LL) and thoracic kyphosis. The C7N group had significantly lower SVA\n COG<\/jats:bold>\n (center of gravity of the head) and SVA\n C7<\/jats:bold>\n (32.9 and \u201349.5 mm) values than the C7P group (115.9 and 45.1 mm). Sagittal curvatures were also different in T4-12, T10-L2, LL4-S, and LL. The value of pelvic incidence (PI)-LL was different (C7N vs C7P; \u20132.2\u00b0 vs 9.9\u00b0;\n P<\/jats:italic>\n < .0003). Compensatory sagittal curvatures were associated with potential for shifting of SVA\n C7<\/jats:bold>\n posteriorly to adjust head position. PI-LL affected these compensatory mechanisms.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n \n Compensation in symptomatic primary C-kypho was via posterior shifting of SVA\n C7<\/jats:bold>\n , small T1 slope, and large LL. However, even in C-kypho patients, lumbar degeneration might affect global spinal alignment. Thus, global spinal alignment with cervical kyphosis is characterized as head balanced or trunk balanced.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyx288","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T05:22:10Z","timestamp":1493702530000},"page":"686-694","source":"Crossref","is-referenced-by-count":46,"title":["Global Spinal Alignment in Cervical Kyphotic Deformity: The Importance of Head Position and Thoracolumbar Alignment in the Compensatory Mechanism"],"prefix":"10.1227","volume":"82","author":[{"given":"Jun","family":"Mizutani","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, California"},{"name":"Department of Rehabilitation Medicine and Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kushagra","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine and International University of Health and Welfare (IUHW), Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniyoshi","family":"Abumi","sequence":"additional","affiliation":[{"name":"Sapporo Orthopaedic Hospital, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, National Hospital Organization Murayama Medical Center, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naobumi","family":"Hosogane","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery National Defence Medical College, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Yang","sequence":"additional","affiliation":[{"name":"University of California San Francisco Medical School, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Deviren","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5]]},"reference":[{"issue":"6","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3171\/SPI.2008.10.08226","article-title":"Circumferential fusion for cervical kyphotic deformity","volume":"9","author":"Mummaneni","year":"2008","journal-title":"J Neurosurg 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