{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T03:07:31Z","timestamp":1769915251516,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Cervical sagittal alignment (CSA) is related to function and quality of life, but it has not been frequently studied in patients with adolescent idiopathic scoliosis. This study aimed to reveal the change in CSA following corrective surgery, compare the cervical sagittal parameters according to curve types, and assess related factors for postoperative aggravation of CSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors studied 318 consecutive patients with adolescent idiopathic scoliosis who underwent corrective surgery at a single center. Occiput\u2013C2 and C2\u20137 lordosis, C2\u20137 sagittal vertical axis (SVA), T-1 slope, thoracic kyphosis, and lumbar sagittal profiles were measured preoperatively and postoperatively. Scoliosis Research Society Outcomes Questionnaire (SRS-22) scores were used as clinical outcomes. Each radiological parameter was compared preoperatively and postoperatively according to curve types (double major, single thoracic, and double thoracic curves). Patients were grouped based on preoperative CSA: the lordotic group (group L) and the kyphotic group (group K). Each radiological parameter was compared between the groups. Related factors for postoperative aggravation of CSA were assessed using multivariate logistic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of the total number of patients studied, 67.0% (213 of 318) and 54.4% (173 of 318) showed cervical kyphotic alignment preoperatively and postoperatively, respectively. C2\u20137 lordosis increased (from \u22125.8\u00b0 to \u22121.1\u00b0; p &lt; 0.001) and C2\u20137 SVA decreased (from 24.2 to 20.0 mm; p &lt; 0.001) postoperatively regardless of curve types. Although group K showed improvement in C2\u20137 lordosis (from \u221212.7\u00b0 to \u22124.8\u00b0; p &lt; 0.001), group L showed no difference (from 9.0\u00b0 to 6.9\u00b0; p = 0.115) postoperatively. Clinical outcomes were not related to the degree of cervical kyphosis in this cohort. C2\u20137 lordosis (p &lt; 0.001) and pelvic tilt (p = 0.019) were related to postoperative aggravation of CSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Regardless of the trend of improvement in CSA, many patients (54.4%) still showed cervical kyphotic alignment postoperatively. C2\u20137 lordosis and C2\u20137 SVA improved postoperatively in all curve types. However, postoperative changes in C2\u20137 lordosis showed different results based on preoperative CSA, which could be related to T-1 slope and thoracic kyphosis. However, clinical outcomes showed no difference based on CSA in this study cohort. Greater C2\u20137 lordosis and proximal thoracic curve preoperatively were risk factors for postoperative aggravation of CSA (p &lt; 0.001 and p = 0.019, respectively).<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.8.peds17357","type":"journal-article","created":{"date-parts":[[2017,12,15]],"date-time":"2017-12-15T14:55:52Z","timestamp":1513349752000},"page":"292-301","source":"Crossref","is-referenced-by-count":16,"title":["Cervical sagittal alignment in patients with adolescent idiopathic scoliosis: is it corrected by surgery?"],"prefix":"10.3171","volume":"21","author":[{"given":"Jae Hwan","family":"Cho","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Ju","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Hyun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Choon Sung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1007\/s00586-011-1837-z","article-title":"Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis","volume":"20","author":"Canavese F","year":"2011","unstructured":"Canavese F, Turcot K, De Rosa V, de Coulon G, Kaelin A: Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. 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