{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:28:08Z","timestamp":1786728488763,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To optimize quality of life in patients with cervical deformity (CD), there may be alignment targets to be prioritized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To prioritize the cervical parameter targets for alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Included: CD patients (C2\u2013C7 Cobb &gt;10\n                      <jats:sup>\u00b0<\/jats:sup>\n                      \u00b0, C2\u2013C7 lordosis [CL] &gt;10\n                      <jats:sup>\u00b0<\/jats:sup>\n                      \u00b0, cSVA &gt; 4 cm, or chin-brow vertical angle &gt;25\n                      <jats:sup>\u00b0<\/jats:sup>\n                      \u00b0) with full baseline (BL) and 1-year (1Y) radiographic parameters and Neck Disability Index (NDI) scores; patients with cervical (C) or cervicothoracic (CT) Primary Driver Ames type. Patients with BL Ames classified as low CD for both parameters of cSVA (&lt;4 cm) and T1 slope minus CL (TS-CL) (&lt;15\n                      <jats:sup>\u00b0<\/jats:sup>\n                      \u00b0) were excluded. Patients assessed: Meeting Minimal Clinically Important Difference (MCID) for NDI (&lt;\u221215 \u0394NDI). Ratios of correction were found for regional parameters categorized by Primary Ames Driver (C or CT). Decision tree analysis assessed cut-offs for differences associated with meeting NDI MCID at 1Y.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventy-seven CD patients (62.1 years, 64%F, 28.8 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). 41.6% met MCID for NDI. A backward linear regression model including radiographic differences as predictors from BL to 1Y for meeting MCID for NDI demonstrated an\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.820 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.032) included TS-CL, cSVA, MGS, C2SS, C2-T3 angle, C2-T3 sagittal vertical axis (SVA), CL. By primary Ames driver, 67.5% of patients were C, and 32.5% CT. Ratios of change in predictors for MCID NDI patients for C and CT were not significant between the two groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.050). Decision tree analysis determined cut-offs for radiographic change, prioritizing in the following order: \u226542.5\n                      <jats:sup>\u00b0<\/jats:sup>\n                      C2-T3 angle, &gt;35.4\n                      <jats:sup>\u00b0<\/jats:sup>\n                      CL, &lt;\u221231.76\n                      <jats:sup>\u00b0<\/jats:sup>\n                      C2 slope, &lt;\u221211.57 mm cSVA, &lt;\u22122.16\n                      <jats:sup>\u00b0<\/jats:sup>\n                      MGS, &gt;\u221230.8 mm C2-T3 SVA, and \u2264\u221233.6\n                      <jats:sup>\u00b0<\/jats:sup>\n                      TS-CL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Certain ratios of correction of cervical parameters contribute to improving neck disability. Prioritizing these radiographic alignment parameters may help optimize patient-reported outcomes for patients undergoing CD surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_26_21","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T14:48:37Z","timestamp":1631026117000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Prioritization of realignment associated with superior clinical outcomes for surgical cervical deformity patients"],"prefix":"10.4103","volume":"12","author":[{"given":"Katherine E.","family":"Pierce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Gust","family":"Passias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avery 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