{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:25:11Z","timestamp":1791617111421,"version":"4.3.4"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to evaluate spinopelvic sagittal alignment and spinal compensatory changes in adult cervical kyphotic deformity.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A database composed of 13 US spine centers was retrospectively reviewed for adult patients who underwent cervical reconstruction with radiographic evidence of cervical kyphotic deformity: C2\u20137 sagittal vertical axis &gt; 4 cm, chin-brow vertical angle &gt; 25\u00b0, or cervical kyphosis (T1 slope [T1S] cervical lordosis [CL] &gt; 15\u00b0) (n = 129). Sagittal parameters were evaluated preoperatively and in the early postoperative window (6 weeks to 6 months postoperatively) and compared with asymptomatic control patients. Adult cervical deformity patients were further stratified by degree of cervical kyphosis (severe kyphosis, C2\u2013T3 Cobb angle \u2264 \u221230\u00b0; moderate kyphosis, \u2264 0\u00b0; and minimal kyphosis, &gt; 0\u00b0) and severity of sagittal malalignment (severe malalignment, sagittal vertical axis T3\u2013S1 \u2264 \u221260 mm; moderate malalignment, \u2264 20 mm; and minimal malalignment &gt; 20 mm).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Compared with asymptomatic control patients, cervical deformity was associated with increased C0\u20132 lordosis (32.9\u00b0 vs 23.6\u00b0), T1S (33.5\u00b0 vs 28.0\u00b0), thoracolumbar junction kyphosis (T10\u2013L2 Cobb angle \u22127.0\u00b0 vs \u22121.7\u00b0), and pelvic tilt (PT) (19.7\u00b0 vs 15.9\u00b0) (p &lt; 0.01). Cervicothoracic kyphosis was correlated with C0\u20132 lordosis (R = \u22120.57, p &lt; 0.01) and lumbar lordosis (LL) (R = \u22120.20, p = 0.03). Cervical reconstruction resulted in decreased C0\u20132 lordosis, increased T1S, and increased thoracic and thoracolumbar junction kyphosis (p &lt; 0.01). Patients with severe cervical kyphosis (n = 34) had greater C0\u20132 lordosis (p &lt; 0.01) and postoperative reduction of C0\u20132 lordosis (p = 0.02) but no difference in PT. Severe cervical kyphosis was also associated with a greater increase in thoracic and thoracolumbar junction kyphosis postoperatively (p = 0.01). Patients with severe sagittal malalignment (n = 52) had decreased PT (p = 0.01) and increased LL (p &lt; 0.01), as well as a greater postoperative reduction in LL (p &lt; 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Adult cervical deformity is associated with upper cervical hyperlordotic compensation and thoracic hypokyphosis. In the setting of increased kyphotic deformity and sagittal malalignment, thoracolumbar junction kyphosis and lumbar hyperlordosis develop to restore normal center of gravity. There was no consistent compensatory pelvic retroversion or anteversion among the adult cervical deformity patients in this cohort.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.spine221295","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T13:14:04Z","timestamp":1679663644000},"page":"1-10","source":"Crossref","is-referenced-by-count":12,"title":["Spinopelvic sagittal compensation in adult cervical deformity"],"prefix":"10.3171","volume":"39","author":[{"given":"Jichao","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Rider","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali S.","family":"Farooqi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Passias","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric O.","family":"Klineberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled M.","family":"Kebaish","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin K.","family":"Scheer","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Scripps Clinic Torrey Pines, La Jolla, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Soroceanu","sequence":"additional","affiliation":[{"name":"University of Calgary Spine Program, University of Calgary, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Rocky Mountain Hospital for Children, Presbyterian\/St. Luke\u2019s Medical Center, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Orthopedic Surgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munish C.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri; 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