{"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":1782027539864,"version":"3.54.5"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"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":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Single center, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Little is known about the surgical outcomes and quality of life in patients with C2-sacrum posterior spinal fusion (PSF). Though it is thought to be a \u201cfinal\u201d construct, it remains unknown how patients fare postoperatively. We sought to evaluate the surgical outcomes and quality of life of patients after C2-sacrum PSF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients undergoing C2-Sacrum PSF from 2015-2020 by 4 surgeons at a single institution were included. The study time period for each patient began after their index operation that led to the C2-sacrum fusion. Dates of surgery, complications, reoperations, patient reported outcomes (PROs) including EuroQol 5 Dimensions (EQ-5D), Oswestry Disability Index (ODI), Scoliosis Research Society (SRS) questionnaires, and activities of daily living (ADL) questions were collected and analyzed. Descriptive statistics, paired t-tests, student t-tests, and linear regression were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 23 patients who underwent C2-sacrum PSF, 6 patients (26%) required a total of 10 reoperations after a mean of 1.5\u00a0years (range 0-4\u00a0years) after C2-sacrum PSF. Five reoperations were for mechanical failure; 3 for wound complications\/infection; and 2 for instrumentation and spinous process prominence. PROs were collected on 18 patients with mean follow-up of 2.4 years (range .5-4.5) after their C2-sacrum PSF. At 6-months, both SRS-22 and ODI scores improved significantly after C2-sacrum PSF (SRS: 57.5 to 76.3, P = .0014; ODI: 47.0 to 31.7, P = .013). Similarly, at a mean 2.4\u00a0years postoperatively, mean ODI improved significantly (47.0 to 30.4, P = .0032). Six patients (33%) had minimal symptoms (ODI &lt;20). The median postoperative EQ-5D score was .74 (range .19 to 1.0), which compares favorably to patients with hip\/knee osteoarthritis (EQ-5D .63) and diabetes mellitus (DM) (EQ-5D .69) and hypertension (HTN). In terms of activities of daily living (ADL), 10 patients (56%) exercised regularly\u2014a mean 4.5 days\/week. 11 (61%) could do light aerobic activity (e.g. stationary bike). 10 (55%) were able to play with children\/grandchildren as desired. Eight patients (44%) hiked, and 2 (11%) drove independently. 11 (61%) could tolerate short air-travel comfortably. Of the 17 patients who could toilet and perform basic hygiene preoperatively, 16 (94%) were able to do so postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Though C2-sacrum PSF is thought to be a \u201cfinal\u201d construct, approximately 1 in 4 patients require subsequent operations. However, C2-sacrum PSF patients had a significant improvement in SRS and ODI scores by 6 months postop. Over 60% of patients were regularly performing light aerobic activity 2\u00a0years after their C2-sacrum PSF. EQ-5D suggests that this population fares better than those with degenerative hip\/knee arthritis and similarly to those with common chronic conditions like DM and HTN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221149389","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:26:52Z","timestamp":1672964812000},"page":"1542-1551","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Living with a C2-Sacrum Spinal Fusion: Surgical Outcomes and Quality of Life in Patients Fused from C2 to the Sacrum"],"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Marciano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Simhon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Cerpa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkat","family":"Boddapati","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald A.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeshan M.","family":"Sardar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc D.","family":"Dyrszka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"bibr1-21925682221149389","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5093-8"},{"key":"bibr2-21925682221149389","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217705655"},{"key":"bibr3-21925682221149389","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181753c53"},{"key":"bibr4-21925682221149389","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.888"},{"key":"bibr5-21925682221149389","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-008-0044-0"},{"key":"bibr6-21925682221149389","doi-asserted-by":"publisher","DOI":"10.3171\/2016.8.SPINE151543"},{"key":"bibr7-21925682221149389","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000138272.54896.33"},{"key":"bibr8-21925682221149389","author":"Makino T","journal-title":"ingentaconnect.com"},{"key":"bibr9-21925682221149389","volume-title":"Outcomes of Posterior 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