{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T01:10:10Z","timestamp":1751073010569,"version":"3.41.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Extension crosswise osteotomy at C7 (C7 ECO) was developed for the correction of forward gaze in patients with chin-on-chest deformity due to ankylosing spondylitis. A modification of cervicothoracic extension osteoclasis (C\/T EO), C7 ECO replaces osteoclasis of the anterior column with a crosswise cut of the C7 vertebral body to eliminate the risks of unintended dislocation of the cervical spine. C7 ECO also eliminates the risks of C7 and T1 pedicle subtraction osteotomies (C\/T PSOs), in which a posteriorly based wedge excision may lead to stretching injuries of the lower cervical roots and\/or failure to achieve the exact angle of excision required for an optimal correction. Furthermore, opening the osteotomy anteriorly, as in the authors\u2019 method, instead of closing it posteriorly, as in PSO, eliminates the risks related to shortening of the posterior column, such as buckling of the dura, kinking of the spinal cord, and stretching of the lower cervical nerve roots. Here, the authors report the use of C7 ECO for the surgical treatment of a 69-year-old man with severe compromise of his forward gaze due to chin-on-chest deformity in the course of ankylosing spondylitis. After uneventful correction surgery, the patient regained the ability to see objects, namely faces of people, at the level of his head while standing and to perform work tasks at a desk.<\/jats:p>","DOI":"10.3171\/2020.7.spine20258","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T07:18:31Z","timestamp":1605856711000},"page":"424-429","source":"Crossref","is-referenced-by-count":2,"title":["C7 extension crosswise osteotomy: a novel osteotomy for correction of chin-on-chest deformity in a patient with ankylosing spondylitis"],"prefix":"10.3171","volume":"34","author":[{"given":"Andrzej","family":"Maciejczak","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, St. Lukas Hospital, Tarn\u00f3w; and"},{"name":"Medical Faculty, University of Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andzelina","family":"Wolan-Nieroda","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Guzik","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"291","DOI":"10.2106\/00004623-195941020-00011","article-title":"Vertebral osteotomy for kyphosis, especially in Marie-Strumpell arthritis; a report on fifty cases","volume":"41-A","author":"Herbert JJ","year":"1959","unstructured":"Herbert JJ. Vertebral osteotomy for kyphosis, especially in Marie-Strumpell arthritis; a report on fifty cases. J Bone Joint Surg Am. 1959;41-A(2):291\u2013302.10.2106\/00004623-195941020-0001113630965"},{"issue":"1","key":"b2","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/FOC\/2008\/24\/1\/E9","article-title":"Management of cervical deformity in ankylosing spondylitis","volume":"24","author":"Hoh DJ","year":"2008","unstructured":"Hoh DJ, Khoueir P, Wang MY. Management of cervical deformity in ankylosing spondylitis. Neurosurg Focus. 2008;24(1):E9.1829074710.3171\/FOC\/2008\/24\/1\/E9"},{"issue":"6","key":"b3","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"579","DOI":"10.3171\/SPI\/2008\/8\/6\/579","article-title":"Use of hinged rods for controlled osteoclastic correction of a fixed cervical kyphotic deformity in ankylosing spondylitis","volume":"8","author":"Khoueir P","year":"2008","unstructured":"Khoueir P, Hoh DJ, Wang MY. Use of hinged rods for controlled osteoclastic correction of a fixed cervical kyphotic deformity in ankylosing spondylitis. J Neurosurg Spine. 2008;8(6):579\u2013583.10.3171\/SPI\/2008\/8\/6\/57918518681"},{"issue":"4","key":"b4","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1007\/s00586-012-2596-1","article-title":"Non-instrumented correction of cervicothoracic kyphosis in ankylosing spondylitis: a critical analysis on the results of open-wedge osteotomy C7-T1 with gradual Halo-Thoracic-Cast based correction","volume":"22","author":"Koller H","year":"2013","unstructured":"Koller H, Meier O, Zenner J,  Non-instrumented correction of cervicothoracic kyphosis in ankylosing spondylitis: a critical analysis on the results of open-wedge osteotomy C7-T1 with gradual Halo-Thoracic-Cast based correction. Eur Spine J. 2013;22(4):819\u2013832.2318816210.1007\/s00586-012-2596-1"},{"issue":"9","key":"b5","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1097\/BRS.0b013e3181fc1a5e","article-title":"A safe controlled instrumented reduction technique for cervical osteotomy in ankylosing spondylitis","volume":"36","author":"Mehdian S","year":"2011","unstructured":"Mehdian S, Arun R. A safe controlled instrumented reduction technique for cervical osteotomy in ankylosing spondylitis. Spine (Phila Pa 1976). 2011;36(9):715\u2013720.10.1097\/BRS.0b013e3181fc1a5e21289582"},{"issue":"6","key":"b6","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s005860050215","article-title":"Cervical osteotomy for ankylosing spondylitis: an innovative variation on an existing technique","volume":"8","author":"Mehdian SMH","year":"1999","unstructured":"Mehdian SMH, Freeman BJC, Licina P. Cervical osteotomy for ankylosing spondylitis: an innovative variation on an existing technique. Eur Spine J. 1999;8(6):505\u2013509.10.1007\/s005860050215"},{"issue":"1","key":"b7","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.3171\/foc.2003.14.1.10","article-title":"Cervical osteotomy for the correction of chin-on-chest deformity in ankylosing spondylitis","volume":"14","author":"Mummaneni PV","year":"2003","unstructured":"Mummaneni PV, Mummaneni VP, Haid RW Jr,  Cervical osteotomy for the correction of chin-on-chest deformity in ankylosing spondylitis. Neurosurg Focus. 2003;14(1):e9.10.3171\/foc.2003.14.1.1015766226"},{"issue":"26","key":"b8","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"3006","DOI":"10.1097\/01.brs.0000250663.12224.d9","article-title":"Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes","volume":"31","author":"Simmons ED","year":"2006","unstructured":"Simmons ED, DiStefano RJ, Zheng Y, Simmons EH. Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes. Spine (Phila Pa 1976). 2006;31(26):3006\u20133012.10.1097\/01.brs.0000250663.12224.d917172997"},{"issue":"86","key":"b9","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1097\/00003086-197207000-00019","article-title":"The surgical correction of flexion deformity of the cervical spine in ankylosing spondylitis","volume":"86","author":"Simmons EH","year":"1972","unstructured":"Simmons EH. The surgical correction of flexion deformity of the cervical spine in ankylosing spondylitis. Clin Orthop Relat Res. 1972;86(86):132\u2013143.10.1097\/00003086-197207000-000195047778"},{"issue":"16","key":"b10","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E559","DOI":"10.1097\/BRS.0b013e31817c6c64","article-title":"Surgical management of symptomatic cervical or cervicothoracic kyphosis due to ankylosing spondylitis","volume":"33","author":"Etame AB","year":"2008","unstructured":"Etame AB, Than KD, Wang AC,  Surgical management of symptomatic cervical or cervicothoracic kyphosis due to ankylosing spondylitis. Spine (Phila Pa 1976). 2008;33(16):E559\u2013E564.10.1097\/BRS.0b013e31817c6c64"},{"issue":"suppl 1","key":"b11","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.1007\/s00586-014-3655-6","article-title":"Three-column osteotomies of the lower cervical and upper thoracic spine: comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients","volume":"24","author":"Theologis AA","year":"2015","unstructured":"Theologis AA, Tabaraee E, Funao H,  Three-column osteotomies of the lower cervical and upper thoracic spine: comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients. Eur Spine J. 2015;24(suppl 1):S23\u2013S30.2539486210.1007\/s00586-014-3655-6"},{"issue":"9","key":"b12","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1007\/s00586-006-0290-x","article-title":"C7 decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis","volume":"16","author":"Tokala DP","year":"2007","unstructured":"Tokala DP, Lam KS, Freeman BJ, Webb JK. C7 decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis. Eur Spine J. 2007;16(9):1471\u20131478.1733479510.1007\/s00586-006-0290-x"},{"issue":"3","key":"b13","series-title":"Calif Med","first-page":"244","article-title":"Surgical correction of flexion deformity of the cervical spine","volume":"79","author":"Mason C","year":"1953","unstructured":"Mason C, Cozen L, Adelstein L. Surgical correction of flexion deformity of the cervical spine. Calif Med. 1953;79(3):244\u2013246.13082429"},{"issue":"4","key":"b14","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"833","DOI":"10.2106\/00004623-195840040-00007","article-title":"Osteotomy of the cervical spine; report of a case of ankylosing rheumatoid spondylitis","volume":"40-A","author":"Urist MR","year":"1958","unstructured":"Urist MR. Osteotomy of the cervical spine; report of a case of ankylosing rheumatoid spondylitis. J Bone Joint Surg Am. 1958;40-A(4):833\u2013843.10.2106\/00004623-195840040-0000713549520"},{"key":"b15","series-title":"J Bone Jt Surg","first-page":"1","article-title":"Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis","volume":"27","author":"Smith-Petersen MN","year":"1945","unstructured":"Smith-Petersen MN, Larson CB, Aufranc OE. Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. J Bone Jt Surg. 1945;27:1\u201311."},{"issue":"3","key":"b16","series-title":"Can J Surg","first-page":"215","article-title":"Gradual multiplanar cervical osteotomy to correct kyphotic ankylosing spondylitic deformities","volume":"45","author":"Bouchard JA","year":"2002","unstructured":"Bouchard JA, Feibel RJ. Gradual multiplanar cervical osteotomy to correct kyphotic ankylosing spondylitic deformities. Can J Surg. 2002;45(3):215\u2013218.12067180"},{"issue":"2","key":"b17","series-title":"Akt Rheumatol","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1055\/s-2008-1047911","article-title":"Die zervikale Aufrichtungsosteotomie nach Mason und Urist bei Spondylarthritis ankylopoetica","volume":"12","author":"Hehne HJ","year":"1987","unstructured":"Hehne HJ, Zielke K. Die zervikale Aufrichtungsosteotomie nach Mason und Urist bei Spondylarthritis ankylopoetica. Akt Rheumatol. 1987;12(2):126\u2013130.10.1055\/s-2008-1047911"},{"issue":"8","key":"b18","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1007\/s00586-009-1142-2","article-title":"Correction and stabilisation in ankylosing spondylitis of the cervicothoracic spine","volume":"18","author":"Pavlov PW","year":"2009","unstructured":"Pavlov PW. Correction and stabilisation in ankylosing spondylitis of the cervicothoracic spine. Eur Spine J. 2009;18(8):1243\u20131244.10.1007\/s00586-009-1142-219693546"},{"issue":"2","key":"b19","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3171\/2011.3.SPINE10536","article-title":"Technique of cervicothoracic junction pedicle subtraction osteotomy for cervical sagittal imbalance: report of 11 cases","volume":"15","author":"Deviren V","year":"2011","unstructured":"Deviren V, Scheer JK, Ames CP. Technique of cervicothoracic junction pedicle subtraction osteotomy for cervical sagittal imbalance: report of 11 cases. J Neurosurg Spine. 2011;15(2):174\u2013181.2152912810.3171\/2011.3.SPINE10536"},{"issue":"16","key":"b20","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1017","DOI":"10.1097\/BRS.0b013e31824ee031","article-title":"Surgical treatment of \u201cchin-on-pubis\u201d deformity in a patient with ankylosing spondylitis: a case report of consecutive cervical, thoracic, and lumbar corrective osteotomies","volume":"37","author":"Kim KT","year":"2012","unstructured":"Kim KT, Lee SH, Son ES,  Surgical treatment of \u201cchin-on-pubis\u201d deformity in a patient with ankylosing spondylitis: a case report of consecutive cervical, thoracic, and lumbar corrective osteotomies. Spine (Phila Pa 1976). 2012;37(16):E1017\u2013E1021.10.1097\/BRS.0b013e31824ee031"},{"issue":"6","key":"b21","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3171\/2010.5.SPINE08608","article-title":"Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy. Presented at the 2009 Joint Spine Section Meeting","volume":"13","author":"Samudrala S","year":"2010","unstructured":"Samudrala S, Vaynman S, Thiayananthan T,  Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy. Presented at the 2009 Joint Spine Section Meeting. J Neurosurg Spine. 2010;13(6):695\u2013706.10.3171\/2010.5.SPINE0860821121746"},{"issue":"suppl 1","key":"b22","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s00586-016-4931-4","article-title":"Asymmetric C7 pedicle subtraction osteotomy for correction of rigid cervical coronal imbalance secondary to post-traumatic heterotopic ossification: a case report, description of a novel surgical technique, and literature review","volume":"26","author":"Theologis AA","year":"2017","unstructured":"Theologis AA, Bellevue KD, Qamirani E,  Asymmetric C7 pedicle subtraction osteotomy for correction of rigid cervical coronal imbalance secondary to post-traumatic heterotopic ossification: a case report, description of a novel surgical technique, and literature review. Eur Spine J. 2017;26(suppl 1):141\u2013145.10.1007\/s00586-016-4931-428032224"},{"issue":"5","key":"b23","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"487","DOI":"10.3171\/2016.8.SPINE121065","article-title":"T-1 pedicle subtraction osteotomy for the treatment of rigid cervical kyphotic deformity: report of 4 cases","volume":"27","author":"Tobin MK","year":"2017","unstructured":"Tobin MK, Birk DM, Rangwala SD,  T-1 pedicle subtraction osteotomy for the treatment of rigid cervical kyphotic deformity: report of 4 cases. J Neurosurg Spine. 2017;27(5):487\u2013493.10.3171\/2016.8.SPINE12106528841105"},{"issue":"45","key":"b24","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002027","article-title":"Comparison of clinical and radiological improvement between the modified trephine and high-speed drill as main osteotomy instrument in pedicle subtraction osteotomy","volume":"94","author":"Wang H","year":"2015","unstructured":"Wang H, Ma L, Yang D,  Comparison of clinical and radiological improvement between the modified trephine and high-speed drill as main osteotomy instrument in pedicle subtraction osteotomy. Medicine (Baltimore). 2015;94(45):e2027.10.1097\/MD.000000000000202726559307"},{"issue":"8","key":"b25","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1007\/s00586-017-5071-1","article-title":"Three-column osteotomy for correction of cervical and cervicothoracic deformities: alignment changes and early complications in a multicenter prospective series of 23 patients","volume":"26","author":"Smith JS","year":"2017","unstructured":"Smith JS, Shaffrey CI, Lafage R,  Three-column osteotomy for correction of cervical and cervicothoracic deformities: alignment changes and early complications in a multicenter prospective series of 23 patients. Eur Spine J. 2017;26(8):2128\u20132137.10.1007\/s00586-017-5071-1"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/34\/3\/article-p424.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/34\/3\/article-p424.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/34\/3\/article-p424.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:57:29Z","timestamp":1751072249000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/34\/3\/article-p424.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":25,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2020.7.spine20258","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}