{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T14:08:52Z","timestamp":1769263732791,"version":"3.49.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"\nOBJECTIVE<\/jats:title>\nNo reports have investigated how cervical reconstructive surgery affects global sagittal alignment (GSA), including the lower extremities, and health-related quality of life (HRQOL). The study was aimed at elucidating the effects of cervical reconstruction on GSA and HRQOL.<\/jats:p>\n<\/jats:sec>\n\nMETHODS<\/jats:title>\nTwenty-three patients who underwent reconstructive surgery for cervical kyphosis were divided into a head-balanced group (n = 13) and a trunk-balanced group (n = 10) according to the values of the C7 plumb line, T1 slope (T1S), and pelvic incidence minus lumbar lordosis (PI-LL). Head-balanced patients are those with a negative C7 sagittal vertical axis (SVA), a larger LL than PI, and a low T1S. Trunk-balanced patients are those with a positive SVAC7<\/jats:sub>, a normal PI-LL, and a normal to high T1S. Various sagittal Cobb angles, SVA, and lower-extremity alignment parameters were measured before and after surgery using whole-body stereoradiography.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nCervical malalignment was corrected to achieve cervical sagittal balance and occiput-trunk (OT) concordance (center of gravity [COG]\u2013C7 SVA < 30 mm). Significant changes in the upper cervical spine and thoracolumbar spine were observed in the head-balanced group, but no significant change in lumbopelvic alignment was observed in the trunk-balanced group. Lower-extremity alignment did not change substantially in either group. HRQOL scores improved significantly after surgery in both groups. SVACOG\u2013C7<\/jats:sub> and SVAC2\u20137<\/jats:sub> were negatively and positively correlated with the 36-Item Short-Form Health Survey physical component score and Neck Disability Index, respectively. The visual analog scale for back pain, Oswestry Disability Index, and PI-LL mismatch improved significantly in the head-balanced group after cervical reconstruction surgery.<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nPatients with cervical kyphosis exhibited compensatory changes in the upper cervical spine and thoracolumbar spine, instead of in the lower extremities. These compensatory mechanisms resolved reciprocally in a different fashion in the head- and trunk-balanced groups. HRQOL scores improved significantly with GSA restoration and OT concordance following cervical reconstruction.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2020.9.spine201309","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T07:20:06Z","timestamp":1617348006000},"page":"839-848","source":"Crossref","is-referenced-by-count":15,"title":["The differential effect of cervical kyphosis correction surgery on global sagittal alignment and health-related quality of life according to head- and trunk-balanced subtype"],"prefix":"10.3171","volume":"34","author":[{"given":"Seung-Jae","family":"Hyun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki-Jeong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae-Ahn","family":"Jahng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"r1","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1093\/neuros\/nyx477","article-title":"Cervical spine deformity\u2014part 3: posterior techniques, clinical outcome, and complications","volume":"81","author":"Tan LA","year":"2017","unstructured":"Tan LA, Riew KD, Traynelis VC. 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