{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:17:16Z","timestamp":1777659436917,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\/Hypothesis: Patients undergoing C2-sacrum PSF have unique medical histories and multiple prior operations over an extended period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single center, retrospective cohort<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive C2-sacrum PSF patients operated on by 4 surgeons at a single-center from 2015-2020 were reviewed. Demographics, comorbidities, indications, surgical history, and radiographic parameters were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>23 patients underwent C2-sacrum PSF. 13 (57%) were male, and 21 (91.3%) were adults. Mean age at time of first spine surgery was 44 years (range 5-71) and 53 years (range 14-72) at the time of C2-sacrum PSF. Six patients (26%) had osteoporosis, and 6 patients (26%) had neurologic comorbidities\u2014including Parkinson\u2019s disease (4), cerebral palsy (1), and Brown Sequard syndrome (1). Four (17%) had connective tissue disease. Two patients underwent C2-sacrum PSF as an index procedure: (1) 67M with myelomatous fractures and 124\u00b0 of cervicothoracic kyphosis; (2) 28F with severe Marfan syndrome with 140\u00b0 thoracic scoliosis and 130\u00b0 thoracic kyphosis. The remaining 21 (91%) underwent C2-sacrum PSF as a revision following prior spinal surgeries on average, 4 previous surgeries (range 1-13) over 10.5 years (range .3-37.4). Indications for the remaining 21 C2-sacrum PSF revision procedures included 17 (81%) for kyphosis (5 of whom also had significant coronal deformity), 1 (5%) for only coronal malalignment, 2 (10%) for instrumentation failure, and 1 (5%) for myelopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>91% (21\/23) of patients requiring C2-sacrum PSF were treated as revisions of prior fusions, with a mean of 4 prior surgeries over 10 years. Over 80% of these patients underwent C2-sacrum PSF to address kyphosis. 26% had neurologic conditions, and 26% had osteoporosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221137031","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T23:30:16Z","timestamp":1667863816000},"page":"1210-1219","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["What Radiographic and Clinical Factors Ultimately Necessitate a C2-Sacrum Instrumented Posterior Spinal Fusion?"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-780X","authenticated-orcid":false,"given":"Justin","family":"Mathew","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Marciano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Simhon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-7515","authenticated-orcid":false,"given":"Hannah","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Cerpa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9572-5968","authenticated-orcid":false,"given":"Nathan J","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkat","family":"Boddapati","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald A","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeeshan M","family":"Sardar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc D","family":"Dyrszka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence G","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"bibr1-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.09.009"},{"key":"bibr2-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0b013e3282fb7c7a"},{"key":"bibr3-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699182"},{"key":"bibr4-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-3759-7"},{"key":"bibr5-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000347005.35282.6C"},{"key":"bibr6-21925682221137031","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31819f2080"},{"key":"bibr7-21925682221137031","volume-title":"Neurosurg Focus","author":"Fujimori 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