{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:08:57Z","timestamp":1776132537489,"version":"3.50.1"},"reference-count":44,"publisher":"The Korean Spinal Neurosurgery Society","issue":"3","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"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: Adult cervical deformity (ACD) is a debilitating spinal condition that causes significant pain, neurologic dysfunction, and functional impairment. Surgery is often performed to correct cervical alignment, but the optimal amount of correction required to improve patient-reported outcomes (PROs) are not yet well-defined.Methods: A review of the literature was performed and Fisher z-transformation (Zr) was used to pool the correlation coefficients between alignment parameters and PROs. The strength of correlation was defined according to the following: poor (0 &lt; r \u2264 0.3), fair (0.3 &lt; r \u2264 0.5), moderate (0.5 &lt; r \u2264 0.8), and strong (0.8 &lt; r \u2264 1).Results: Increased C2\u20137 sagittal vertical axis was fairly associated with increased Neck Disability Index (NDI) (pooled Zr = 0.31; 95% confidence interval [CI], -0.03 to 0.58). Changes in T1 slope minus cervical lordosis poorly correlated with NDI (pooled Zr = -0.04; 95% CI, -0.23 to 0.30). Increased C7\u2013S1 was poorly associated with worse EuroQoL 5-Dimension (pooled Zr = -0.22; 95% CI, -0.36 to -0.06). Correction of horizontal gaze did not correlate with legacy metrics. Modified Japanese Orthopedic Association correlated with C2-slope, C7\u2013S1, and C2\u2013S1.Conclusion: Spinal alignment parameters variably correlated with improved health-related quality of life and myelopathy after corrective surgery for ACD. Further studies evaluating legacy PROs, Patient-Reported Outcomes Measurement System, and ACD specific instruments are needed for further validation.<\/jats:p>","DOI":"10.14245\/ns.2040656.328","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T05:53:23Z","timestamp":1621317203000},"page":"533-542","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Association of Spinal Alignment Correction With Patient-Reported Outcomes in Adult Cervical Deformity: Review of the Literature"],"prefix":"10.14245","volume":"18","author":[{"given":"Elie","family":"Massaad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhamed","family":"Hadzipasic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Kiapour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad M.","family":"Lak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ganesh","family":"Shankar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan A.","family":"Zaidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart H.","family":"Hershman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7490-8108","authenticated-orcid":true,"given":"John H.","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5355","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000215553.49728.b0"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.spine14780"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx028"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4103\/jcvjs.jcvjs_52_19"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000000707"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.spine14178"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3171\/2017.7.spine17661"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-019-06079-x"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy144"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000000761"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"ref12","volume-title":"","year":"2016"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx574"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3171\/2017.8.focus17486"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002610"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.03.006"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.03.014"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3171\/2019.7.spine18651"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy435"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.07.020"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002994"},{"key":"ref23","first-page":"537","volume-title":"Relationship between degree of focal kyphosis correction and neurological outcomes for patients undergoing cervical deformity correction surgery: clinical article","author":"Grosso","year":"2013"},{"key":"ref24","first-page":"1375","volume-title":"Principal radiographic characteristics for cervical spinal deformity: a health-related quality-of-life analysis","author":"Bao","year":"2017"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.3171\/2018.2.spine171285"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2017.11.6.959"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3491-8"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opy055"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opy035"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002524"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.05.29"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx175"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000001221"},{"key":"ref34","first-page":"S3","volume-title":"The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH roadmap cooperative group during its first two years","author":"Cella","year":"2007"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.5435\/jaaos-d-15-00404"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000001965"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.10.092"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220972076"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000462074.66077.2b"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.3171\/2018.5.spine171232"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.11.016"},{"key":"ref42","first-page":"141","volume-title":"Cervical spine alignment, sagittal deformity, and clinical implications: a review","author":"Scheer","year":"2013"},{"key":"ref43","first-page":"S149","volume-title":"Cervical radiographical alignment: comprehensive assessment techniques and potential importance in cervical myelopathy","author":"Ames","year":"2013"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.92512"}],"container-title":["Neurospine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2040656-328.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2040656.328","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2040656-328.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T05:44:53Z","timestamp":1632980693000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2040656.328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,30]]},"references-count":44,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"URL":"https:\/\/doi.org\/10.14245\/ns.2040656.328","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":"2020-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","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"}}]}}