{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:47:14Z","timestamp":1787993234070,"version":"build-2784847793"},"reference-count":33,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"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":[[2024,9]]},"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>The primary objective was to evaluate the impact of the upper instrumented level (UIV) being at C2 vs C3 in posterior cervical construct on patient reported outcomes (PROs) up to 24\u00a0months after surgery for cervical degenerative myelopathy (DCM). Secondary objectives were to compare operative time, intra-operative blood loss (IOBL), length of stay (LOS), adverse events (AEs) and re-operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent a posterior cervical instrumented fusion (3 and + levels) with a C2 or C3 UIV, with 24\u00a0months follow-up were analyzed. PROs (NDI, EQ5D, SF-12 PCS\/MCS, NRS arm\/neck pain) were compared using ANCOVA. Operative duration, IOBL, AEs, and re-operation were compared. Subgroup analysis was performed on patient presenting with pre-operative malalignment (cervical sagittal vertical axis \u226540\u00a0mm and\/or T1slope- cervical lordosis &gt;15\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>173 patients were included, of which 41 (24%) had a C2 UIV and 132 (76%) a C3 UIV. There was no statistically significant difference between the groups for the changes in PROs up to 24\u00a0months. Subgroup analysis of patients with pre-operative malalignment showed a trend towards greater improvement in the NDI at 12\u00a0months with a C2 UIV ( P = .054). Operative time, IOBL and peri-operative AEs were more in C2 group ( P &lt; .05). There was no significant difference in LOS and re-operation ( P &gt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this observational study, up to 24\u00a0months after surgery for posterior cervical fusion in DCM greater than 3 levels, PROs appear to evolve similarly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231166605","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T07:09:24Z","timestamp":1679641764000},"page":"2062-2073","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Does Ending a Posterior Construct Proximally at C2 Versus C3 Impact Patient Reported Outcomes in Degenerative Cervical Myelopathy Patients up to 24\u00a0months After the Surgery?"],"prefix":"10.1177","volume":"14","author":[{"given":"Nizar","family":"Algarni","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Dea","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Vancouver BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-5224","authenticated-orcid":false,"given":"Nathan","family":"Evaniew","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-6523","authenticated-orcid":false,"given":"Greg","family":"McIntosh","sequence":"additional","affiliation":[{"name":"Canadian Spine Outcomes and Research Network, Markdale, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley W","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1390-2428","authenticated-orcid":false,"given":"J\u00e9rome","family":"Paquet","sequence":"additional","affiliation":[{"name":"Centre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Quebec City, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson R","family":"Wilson","sequence":"additional","affiliation":[{"name":"Divisions of Orthopaedic and Neurosurgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamilton","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery, London Health Science Centre, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery, McGill UniversityHealth Centre, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nataraj","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of AlbertaHospital, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najmedden","family":"Attabib","sequence":"additional","affiliation":[{"name":"Canada East Spine Centre, Division of Neurosurgery, Horizon Health Network, Saint John, NB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y Raja","family":"Rampersaud","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Cadotte","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9653-5514","authenticated-orcid":false,"given":"Alexandra","family":"Stratton","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery, The Ottawa Hospital, Ottawa, ON, 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