{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:03:47Z","timestamp":1784203427511,"version":"3.55.0"},"reference-count":19,"publisher":"The Korean Spinal Neurosurgery Society","issue":"3","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2021,9,30]]},"abstract":"<jats:p>Objective: Malalignment of the cervical spine can result in cord compression, leading to a myelopathy diagnosis. Whether deformity or myelopathy severity is stronger predictors of surgical outcomes is understudied.Methods: Surgical cervical deformity (CD) patients with baseline (BL) and up to 1-year data were included. Modified Japanese Orthopaedic Association (mJOA) score categorized BL myelopathy (mJOA = 18 excluded), with moderate myelopathy mJOA being 12 to 17 and severe myelopathy being less than 12. BL deformity severity was categorized using the mismatch between T1 slope and cervical lordosis (TS-CL), with CL being the angle between the lower endplates of C2 and C7. Moderate deformity was TS-CL less than or equal to 25\u00b0 and severe deformity was greater than 25\u00b0. Categorizations were combined into 4 groups: group 1 (G1), severe myelopathy and severe deformity; group 2 (G2), severe myelopathy and moderate deformity; group 3 (G3), moderate myelopathy and moderate deformity; group 4 (G4), moderate myelopathy and severe deformity. Univariate analyses determined whether myelopathy or deformity had greater impact on outcomes.Results: One hundred twenty-eight CD patients were included (mean age, 56.5 years; 46% female; body mass index, 30.4 kg\/m2) with a BL mJOA score of 12.8 \u00b1 2.7 and mean TS-CL of 25.9\u00b0 \u00b1 16.1\u00b0. G1 consisted of 11.1% of our CD population, with 21% in G2, 34.6% in G3, and 33.3% in G4. At BL, Neck Disability Index (NDI) was greatest in G2 (p = 0.011). G4 had the lowest EuroQol-5D (EQ-5D) (p &lt; 0.001). Neurologic exam factors were greater in severe myelopathy (p &lt; 0.050). At 1-year, severe deformity met minimum clinically important differences (MCIDs) for NDI more than moderate deformity (p = 0.002). G2 had significantly worse outcomes compared to G4 by 1-year NDI (p = 0.004), EQ-5D (p = 0.028), Numerical Rating Scale neck (p = 0.046), and MCID for NDI (p = 0.001).Conclusion: Addressing severe deformity had increased clinical weight in improving patient-reported outcomes compared to addressing severe myelopathy.<\/jats:p>","DOI":"10.14245\/ns.2040456.228","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T04:54:46Z","timestamp":1632977686000},"page":"628-634","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Myelopathy Severity and Degree of Deformity on Postoperative Outcomes in Cervical Spinal Deformity Patients"],"prefix":"10.14245","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":true,"given":"Peter G.","family":"Passias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Pierce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Kummer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Krol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Passfall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Burhan","family":"Janjua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sciubba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Naessig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel","family":"Diebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5355","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.04.021"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2007.01.003"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.14245\/ns.1938288.144"},{"key":"ref4","first-page":"e555","volume-title":"Cervical spine deformity: indications, considerations, and surgical outcomes","author":"Cho","year":"2019"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002610"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0b013e31826100c9"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3171\/2019.3.spine18703"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000019215"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2006.05.007"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2965-4"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/phm.0b013e3181ec98e6"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.03.006"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0000000000000895"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e31815cf75b"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3171\/2013.2.spine12525"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2003.99.3.0278"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.02.012"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx574"},{"key":"ref19","first-page":"248","volume-title":"Impact of cervical spine deformity on preoperative disease severity and postoperative outcomes following fusion surgery for degenerative cervical myelopathy: sub-analysis of AOSpine North America and International Studies","author":"Kato","year":"2018"}],"container-title":["Neurospine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2040456-228.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2040456.228","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2040456-228.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T05:46:51Z","timestamp":1632980811000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2040456.228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,30]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"URL":"https:\/\/doi.org\/10.14245\/ns.2040456.228","relation":{},"ISSN":["2586-6583","2586-6591"],"issn-type":[{"value":"2586-6583","type":"print"},{"value":"2586-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,30]]},"assertion":[{"value":"2020-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-30","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}