{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:03:05Z","timestamp":1789628585383,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"International Spine Study Group"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"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>Objectives<\/jats:title>\n                    <jats:p>To characterize longitudinal durability of cervical deformity (CD) correction, identify predictors of alignment failure, and define failure mechanism timing across the first postoperative year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>of 155 operative CD patients in a prospectively maintained multicenter database, 89 had complete four-timepoint radiographic follow-up. Well-alignment was defined as cSVA &lt;4 cm. Patients were grouped as A (maintained), B (corrected then deteriorated), or C (never aligned). Analyses included Cox regression (n=47, 17 events), Kaplan\u2013Meier with restricted mean survival time (RMST), and mixed-effects logistic regression across four timepoints (n=356; ICC=0.36). Concurrent thoracolumbar deformity was excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Well-aligned proportion fell from 48.3% at 3 months to 33.7% at 1 year (A=34%, B=19%, C=47%). DJK was most strongly associated with alignment loss (HR 5.21, 95% CI 1.94-13.98; OR 0.09), with alignment maintained 4.1 versus 9.8 months (RMST difference 5.7, p=0.001). Lower postoperative cSVA paradoxically increased failure hazard (HR 0.58\/10 mm, p=0.002). Older patients deteriorated faster (Time\u00d7Age OR 0.88, p=0.022). Failure mechanisms shifted from DJK at 3 months (50%) to PJK at 6 months (75%) to global compensation loss at 1 year (71%). No surgical parameters differed between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fewer than one-third of patients maintain alignment at 1 year. DJK, advanced age, and lower postoperative cSVA were most strongly associated with failure (17 events; limited precision). Mechanisms appeared to shift from junctional failure early to global decompensation late. Alignment loss was not accompanied by significant 1-year NDI or EQ-5D differences, framing radiographic deterioration as an early surveillance marker rather than clinical failure. Individualized risk stratification and surveillance are supported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261490470","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:36:47Z","timestamp":1789220207000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Durability and Failure Mechanisms of Cervical Deformity Correction Surgery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4423-9756","authenticated-orcid":false,"given":"Alexander","family":"Kucherina","sequence":"first","affiliation":[{"name":"NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-1707","authenticated-orcid":false,"given":"Robert","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Scripps Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-4139","authenticated-orcid":false,"given":"Alan","family":"Daniels","sequence":"additional","affiliation":[{"name":"Brown University\/Rhode Island Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Klineberg","sequence":"additional","affiliation":[{"name":"UTHealth Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":false,"given":"Peter","family":"Passias","sequence":"additional","affiliation":[{"name":"Duke Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"UCSF Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Duke Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Schwab","sequence":"additional","affiliation":[{"name":"Northwell Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-7111","authenticated-orcid":false,"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Northwell Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4673-1706","authenticated-orcid":false,"given":"Steven G.","family":"Persaud","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-517X","authenticated-orcid":false,"given":"Paul","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ames","sequence":"additional","affiliation":[{"name":"UCSF Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Lau","sequence":"additional","affiliation":[{"name":"NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4978-2600","authenticated-orcid":false,"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"International Spine Study Group (ISSG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyw048"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31125-0"},{"issue":"3","key":"e_1_3_6_4_2","first-page":"E121","article-title":"Trends in outcomes of a prospective consecutively enrolled single-center adult cervical deformity series","volume":"47","author":"Passias PG","year":"2022","unstructured":"Passias PG, Passfall L, Imbo B, et al. Trends in outcomes of a prospective consecutively enrolled single-center adult cervical deformity series. Spine (Phila Pa 1976). 2022;47(3):E121-E130.","journal-title":"Spine (Phila Pa 1976)"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx574"},{"issue":"6","key":"e_1_3_6_6_2","first-page":"407","article-title":"Analysis of successful versus failed radiographic outcomes after cervical deformity surgery","volume":"43","author":"Protopsaltis TS","year":"2018","unstructured":"Protopsaltis TS, Ramchandran S, Hamilton DK, et al. Analysis of successful versus failed radiographic outcomes after cervical deformity surgery. Spine (Phila Pa 1976). 2018;43(6):407-413.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"e_1_3_6_7_2","first-page":"58","article-title":"Distal junctional failure in posterior cervical and cervicothoracic fusion: a systematic review and meta-analysis","volume":"34","author":"Rostami M","year":"2025","unstructured":"Rostami M, Bagherzadeh S, Traynelis V, Fontes R. Distal junctional failure in posterior cervical and cervicothoracic fusion: a systematic review and meta-analysis. Eur Spine J. 2025;34(1):58-71.","journal-title":"Eur Spine J"},{"issue":"9","key":"e_1_3_6_8_2","first-page":"2128","article-title":"Prospective multicentric evaluation of upper cervical and infra-cervical sagittal compensatory alignment in patients with adult cervical deformity","volume":"27","author":"Ramchandran S","year":"2018","unstructured":"Ramchandran S, Protopsaltis TS, Sciubba D, et al. 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Proximal and distal reciprocal changes following cervical deformity malalignment correction. J Neurosurg Spine. 2022;36(5):740-748.","journal-title":"J Neurosurg Spine"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-08950-2"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.SPINE14780"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a7eb9e"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001221"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003249"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.3171\/2024.12.SPINE24899"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002435"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001171"},{"key":"e_1_3_6_20_2","first-page":"100819","article-title":"A systematic review and meta-analysis of sagittal cervical spine parameters: normative values, correlation with quality of life, and biomechanical modeling","volume":"25","author":"Ferraz VR","year":"2025","unstructured":"Ferraz VR, Goulart CR, Mattei TA. 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