{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:00:26Z","timestamp":1792000826336,"version":"4.4.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The aim of this study was to investigate the influence of preoperatively assessed paraspinal muscle parameters on postoperative patient-reported outcomes and maintenance of cervical sagittal alignment after anterior cervical discectomy and fusion (ACDF).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Patients with preoperative and postoperative standing cervical spine lateral radiographs and preoperative cervical MRI who underwent an ACDF between 2015 and 2018 were reviewed. Muscles from C3 to C7 were segmented into 4 functional groups: anterior, posteromedial, posterolateral, and sternocleidomastoid. The functional cross-sectional area and also the percent fat infiltration (FI) were calculated for all groups. Radiographic alignment parameters collected preoperatively and postoperatively included C2\u20137 lordosis and C2\u20137 sagittal vertical axis (SVA). Neck Disability Index (NDI) scores were recorded preoperatively and at 2 and 4\u20136 months postoperatively. To investigate the relationship between muscle parameters and postoperative changes in sagittal alignment, multivariable linear mixed models were used. Multivariable linear regression models were used to analyze the correlations between the changes in NDI scores and the muscles\u2019 FI.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 168 patients with NDI and 157 patients with sagittal alignment measurements with a median follow-up of 364 days were reviewed. The mixed models showed that a greater functional cross-sectional area of the posterolateral muscle group at each subaxial level and less FI at C4\u20136 were significantly associated with less progression of C2\u20137 SVA over time. Moreover, there was a significant correlation between greater FI of the posteromedial muscle group measured at the C7 level and less NDI improvement at 4\u20136 months after ACDF.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The findings highlight the importance of preoperative assessment of the cervical paraspinal muscle morphology as a predictor for patient-reported outcomes and maintenance of C2\u20137 SVA after ACDF.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.spine23926","type":"journal-article","created":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T01:48:32Z","timestamp":1714787312000},"page":"149-158","source":"Crossref","is-referenced-by-count":17,"title":["Importance of the cervical paraspinal muscles in postoperative patient-reported outcomes and maintenance of sagittal alignment after anterior cervical discectomy and fusion"],"prefix":"10.3171","volume":"41","author":[{"given":"Thomas","family":"Caffard","sequence":"first","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"},{"name":"Department of Orthopedic Surgery, University of Ulm, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artine","family":"Arzani","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Verna","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidushi","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Chiapparelli","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Sch\u00f6nnagel","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"},{"name":"Center for Musculoskeletal Surgery, University of Berlin, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Biostatistics Core, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Medina","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soji","family":"Tani","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"},{"name":"Department of Orthopaedic Surgery, School of Medicine, Showa University Hospital, Tokyo, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaston","family":"Camino-Willhuber","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali E.","family":"Guven","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"},{"name":"Center for Musculoskeletal Surgery, University of Berlin, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krizia","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ek Tsoon","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Carrino","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Shue","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Dobrindt","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Ulm, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Zippelius","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Ulm, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dalton","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Sama","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico P.","family":"Girardi","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank P.","family":"Cammisa","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Spine Care Institute, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"J Neurotrauma","first-page":"1355","article-title":"A global perspective on spinal cord injury epidemiology","volume":"21","author":"Ackery A","year":"2004","unstructured":"Ackery A, Tator C, Krassioukov A. 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