{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T07:38:59Z","timestamp":1782027539869,"version":"3.54.5"},"reference-count":13,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"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":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Determine the indications, complications, and clinical outcomes in patients requiring fusions from the cervical spine to the pelvis. Several investigators have examined fusions from the thoracic spine to the sacrum, but no similar study has been performed for cervical-to-pelvis fusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients from 2003 to 2014 with an upper instrumented vertebrae (UIV) in the cervical spine (any level) and a lower instrumented vertebrae (LIV) in the sacrum or pelvis were included in the study. Those with infectious or acute trauma-related deformities were excluded. Patient demographics, medical history, diagnosis, operative procedure, and health-related quality of life measures were analyzed. Student\u2019s t test, Kruskal-Wallis test, and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test were used as appropriate; significance was set at P &lt; .05 for all tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty-five patients met inclusion criteria for the study. Average follow-up was 2.8 years. Proximal junctional kyphosis was the most common indication for cervical-to-pelvis fusions (36%). The most common UIV was C2 (29%) followed by C7 (24%). There was an average 31\u00b0 correction in maximum kyphosis and a 3.3\u2009cm improvement in sagittal vertical axis. In adults, the rate of complication was 71.4%, with a major complication rate of 39.3% and reoperation rate of 53.6%. There was significant improvement in the Scoliosis Research Society (SRS-22r) score (3.0 to 3.5; P &lt; .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Proximal junctional kyphosis is the most common indication for patients requiring fusion to the cervical spine. Adult patients incur a significant risk of major complications and reoperations. However, significant improvement in SRS-22r outcomes are noted in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568217705655","type":"journal-article","created":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T02:06:27Z","timestamp":1526004387000},"page":"6-13","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Outcomes of Fusions From the Cervical Spine to the Pelvis"],"prefix":"10.1177","volume":"9","author":[{"given":"Sravisht","family":"Iyer","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"},{"name":"Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Theologis","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu M.","family":"Nemani","sequence":"additional","affiliation":[{"name":"Washington University Medical Center, St Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J.","family":"Albert","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"},{"name":"Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY, USA"},{"name":"The Spine Hospital at NewYork-Presbyterian\/Allen, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Burch","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oheneba","family":"Boachie-Adjei","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"},{"name":"FOCOS Orthopedic Hospital, Pantang West, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Deviren","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"New York University Langone Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin K.","family":"Scheer","sequence":"additional","affiliation":[{"name":"University of California\u2013San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Mizutani","sequence":"additional","affiliation":[{"name":"Nagoya City University, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric O.","family":"Kleinberg","sequence":"additional","affiliation":[{"name":"University of California, Davis, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"bibr1-2192568217705655","doi-asserted-by":"publisher","DOI":"10.3171\/2014.3.FOCUS13541"},{"key":"bibr2-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000339"},{"key":"bibr3-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000238970.67552.f5"},{"key":"bibr4-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182376414"},{"key":"bibr5-2192568217705655","doi-asserted-by":"publisher","DOI":"10.3171\/2013.5.SPINE12737"},{"key":"bibr6-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31824fffde"},{"key":"bibr7-2192568217705655","doi-asserted-by":"publisher","DOI":"10.3171\/2013.12.SPINE13680"},{"key":"bibr8-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000761"},{"key":"bibr9-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181ee6bd4"},{"key":"bibr10-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000246"},{"key":"bibr11-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000266"},{"key":"bibr12-2192568217705655","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31829fedde"},{"key":"bibr13-2192568217705655","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.00369"}],"container-title":["Global 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