{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:34:20Z","timestamp":1793252060995,"version":"4.5.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to investigate the risk factors for aggravation of cervical alignment after posterior cervical foraminotomy (PCF) and to identify their relationships with kyphotic changes in cervical curvature.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Ninety-eight patients who underwent PCF for unilateral radiculopathy and received follow-up for more than 2 years were retrospectively reviewed. Segmental Cobb angle (SA), cervical Cobb angle (CA), Pfirrmann grade, foraminal stenosis, and clinical outcomes including neck pain, arm pain, and Neck Disability Index scores were assessed. Radiological and clinical outcomes were compared between groups C (control group with kyphotic change in CA &lt; 5\u00b0) and K (kyphotic group with kyphotic change in CA \u2265 5\u00b0). Multivariate regression analysis was performed to determine the risk factors for kyphotic change \u2265 5\u00b0 after PCF.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Group K was significantly older than group C (p = 0.002) and had a higher Pfirrmann grade (p = 0.025). In group K, neck pain had significantly increased at last follow-up (p &lt; 0.001). Multivariate linear regression analysis revealed that kyphotic changes in CA were related to older age (p = 0.016, B = 0.420) and Pfirrmann grade of the operative levels (p = 0.032, B = 4.560). Preoperative hypolordosis was not an independent risk factor for kyphotic changes in CA. Receiver operating characteristic curve analysis showed that the cutoff value for kyphotic changes in patients with CA \u2265 5\u00b0 was Pfirrmann grade 3.417 (p = 0.008).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Contrary to previous studies, preoperative hypolordosis was not a risk factor for kyphotic changes in CA after PCF. Older patients with disc degeneration of Pfirrmann grade IV or greater for should be carefully considered.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.8.spine22462","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T08:49:54Z","timestamp":1665737394000},"page":"174-181","source":"Crossref","is-referenced-by-count":8,"title":["Predictable factors for aggravation of cervical alignment after posterior cervical foraminotomy"],"prefix":"10.3171","volume":"38","author":[{"given":"Hyung Rae","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Uijeongbu-si, Gyeonggi-do, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Yun","family":"Seok","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Daejeon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woon Sang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hwan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Ju","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Sung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg Spine","first-page":"343","article-title":"Posterior cervical foraminotomy for the treatment of cervical radiculopathy","volume":"10","author":"Fehlings MG","year":"2009","unstructured":"Fehlings MG, Gray RJ. 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