{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T03:56:01Z","timestamp":1780113361002,"version":"3.54.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Correction of rigid cervical deformities can be associated with high complication rates and result in prolonged intensive care unit (ICU) and hospital stays. In this study, the authors aimed to examine the risk factors contributing to length of stay (LOS) in both the hospital and ICU following adult cervical deformity (ACD) surgery and to identify severe adverse events that occurred in this setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A retrospective review of ACD patients who underwent posterior-based osteotomies for deformity correction from 2010 to 2019 was performed. Inclusion criteria were cervical kyphosis &gt; 20\u00b0 and\/or cervical sagittal vertical axis (cSVA) &gt; 4 cm. Multivariate analysis was used to identify risk factors independently associated with ICU and hospital LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 107 patients were included. The mean age was 63.5 years, and 61.7% were female. Over half (52.3%) underwent 3-column osteotomies, while 47.7% underwent posterior column osteotomies. There was significant correction of all cervical parameters: cSVA (6.0 vs 3.6 cm, p &lt; 0.001), cervical lordosis (8.2\u00b0 vs \u22125.3\u00b0, p &lt; 0.001), cervical scoliosis (6.5\u00b0 vs 2.2\u00b0, p &lt; 0.001), and T1-slope (40.2\u00b0 vs 34.5\u00b0, p &lt; 0.001). There were also reciprocal changes to the distal spine: thoracic kyphosis (54.4\u00b0 vs 46.4\u00b0, p &lt; 0.001), lumbar lordosis (49.9\u00b0 vs 45.8\u00b0, p = 0.003), and thoracolumbar scoliosis (13.9\u00b0 vs 11.1\u00b0, p = 0.009). Overall, 4 patients (3.7%) suffered aspiration-related complications, 3 patients (2.8%) experienced dysphagia requiring a feeding tube, and 4 patients (3.7%) had compromised airways, with 1 resulting in death. The mean ICU and hospital LOS were 2.8 days and 7.9 days, respectively. Multivariate analysis identified three factors independently associated with longer ICU LOS: female sex (3.0 vs 2.4 days, p = 0.004), \u2265 12 segments fused (3.5 vs 1.9 days, p = 0.002), and postoperative complication (4.0 vs 1.9 days, p = 0.017). These same factors were independently associated with longer hospital LOS as well: female sex (8.3 vs 7.3 days, p = 0.013), \u2265 12 segments fused (9.4 vs 6.2 days, p = 0.001), and complication (9.7 vs 6.7 days, p = 0.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Posterior-based osteotomies are very effective for the correction of ACD, but postoperative hospital stays are relatively longer than those following surgery for degenerative disease. Risk factors for prolonged ICU and hospital LOS consist of both nonmodifiable (female sex) and modifiable (\u2265 12 segments fused and presence of complication) risk factors. Additional multicenter prospective studies will be needed to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2020.6.spine20826","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T07:19:53Z","timestamp":1603437593000},"page":"178-189","source":"Crossref","is-referenced-by-count":5,"title":["Risk factors for determining length of intensive care unit and hospital stays following correction of cervical deformity: evaluation of early severe adverse events"],"prefix":"10.3171","volume":"34","author":[{"given":"Rushikesh S.","family":"Joshi","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Lau","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander F.","family":"Haddad","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Deviren","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"141","DOI":"10.3171\/2013.4.SPINE12838","article-title":"Cervical spine alignment, sagittal deformity, and clinical implications: a review","volume":"19","author":"Scheer JK","year":"2013","unstructured":"Scheer JK, Tang JA, Smith JS,  Cervical spine alignment, sagittal deformity, and clinical implications: a review. 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