{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:19:00Z","timestamp":1787761140297,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>The study design used was a retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study is to determine if intraoperative improvements in sagittal alignment on the operating table persisted on postoperative standing radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary of Background Data:<\/jats:title>\n                    <jats:p>Cervical sagittal alignment may be correlated to postoperative outcomes. Since anterior cervical discectomy and fusions (ACDFs) can restore some cervical lordosis through intervertebral grafts\/cages, it is important to understand if intraoperative radiographic measurements correlate with persistent postoperative radiographic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Patients undergoing elective primary ACDF were screened for the presence of lateral cervical radiographs preoperatively, intraoperatively, and postoperatively. Patients were excluded if their first postoperative radiograph was more than 3 months following the procedure or if cervical lordosis was not able to be measured at each time point. Paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests were utilized to compare differences in measurements between time points. Statistical significance was set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 46 included patients, 26 (56.5%) were female, and the mean age was 55.2 \u00b1 11.6 years. C0-C2 lordosis significantly increased from the preoperative to intraoperative time point (delta [\u0394] = 4.49,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029) and significantly decreased from the intraoperative to postoperative time period (\u0394 = \u22126.57,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), but this resulted in no significant preoperative to postoperative change (\u0394 = \u22122.08,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.096). C2 slope decreased from the preoperative to the intraoperative time point (\u0394 = \u22123.84,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.043) and significantly increased from the intraoperative to the postoperative time point (\u0394 = 3.68,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.047), which also resulted in no net change in alignment between the preoperative and postoperative periods (\u0394 = \u22120.16,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.848). There was no significant difference in the C2-C7 SVA from the preoperative to intraoperative (\u0394 = 0.85,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.724) or intraoperative to postoperative periods (\u0394 = 2.04,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.401); however, the C2-C7 SVA significantly increased from the preoperative to postoperative period (\u0394 = 2.88,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Intraoperative positioning predominantly affects the mobile upper cervical spine, particularly C0-C2 lordosis and C2 slope, but these changes do not persist postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_100_22","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T22:09:14Z","timestamp":1670364554000},"page":"415-420","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Sagittal alignment differences on the operating room table compared to preoperative and postoperative imaging in anterior cervical discectomy and fusion"],"prefix":"10.4103","volume":"13","author":[{"given":"Mark J.","family":"Lambrechts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory R.","family":"Toci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Karamian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Kozick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Prodoehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Reiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Muchintala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tecce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Vaccaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"O'Connor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Syal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Lambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Canseco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. 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