{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:20:55Z","timestamp":1787775655378,"version":"build-2784847793"},"reference-count":19,"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>Introduction:<\/jats:title>\n                    <jats:p>Osteotomies are commonly performed to correct sagittal malalignment in cervical deformity (CD). However, the risks and benefits of performing a major osteotomy for cervical deformity correction have been understudied. The objective of this retrospective cohort study was to investigate the risks and benefits of performing a major osteotomy for CD correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients stratified based on major osteotomy (MAJ) or minor (MIN). Independent\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and Chi-squared tests were used to assess differences between MAJ and MIN. A sub-analysis compared patients with flexible versus rigid CL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      137 CD patients were included (62 years, 65% F). 19.0% CD patients underwent a MAJ osteotomy. After propensity score matching for cSVA, 52 patients were included. About 19.0% CD patients underwent a MAJ osteotomy. MAJ patients had more minor complications (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045), despite similar surgical outcomes as MIN. At 3M, MAJ and MIN patients had similar NDI, mJOA, and EQ5D scores, however by 1 year, MAJ patients reached MCID for NDI less than MIN patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). MAJ patients with rigid deformities had higher rates of complications (79% vs. 29%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.056) and were less likely to show improvement in NDI at 1 year (0.95 vs. 0.54,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.027). Both groups had similar sagittal realignment at 1 year (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Cervical deformity patients who underwent a major osteotomy had similar clinical outcomes at 3-months but worse outcomes at 1-year as compared to minor osteotomies, likely due to differences in baseline deformity. Patients with rigid deformities who underwent a major osteotomy had higher complication rates and worse clinical improvement despite similar realignment at 1 year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_35_21","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T14:48:37Z","timestamp":1631026117000},"page":"263-268","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Risk-benefit assessment of major versus minor osteotomies for flexible and rigid cervical deformity correction"],"prefix":"10.4103","volume":"12","author":[{"given":"Peter Gust","family":"Passias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Passfall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R.","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Pierce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breton G.","family":"Line","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Eastlack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel G.","family":"Diebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Scheer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas C.","family":"Burton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Hart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-9-20240904","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00586-005-0984-5","article-title":"Sagittal alignment of spine and pelvis regulated by pelvic incidence: Standard values and prediction of lordosis","volume":"15","author":"Boulay","year":"2006","journal-title":"Eur Spine J"},{"key":"R2-9-20240904","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1097\/01.brs.0000155425.04536.f7","article-title":"Correlation of radiographic parameters and clinical symptoms in adult scoliosis","volume":"30","author":"Glassman","year":"2005","journal-title":"Spine (Phila Pa 1976"},{"key":"R3-9-20240904","doi-asserted-by":"crossref","first-page":"378","DOI":"10.5435\/00124635-200906000-00006","article-title":"Sagittal plane deformity in the adult patient","volume":"17","author":"Joseph","year":"2009","journal-title":"J Am Acad Orthop Surg"},{"key":"R4-9-20240904","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.2106\/JBJS.H.00081","article-title":"Corrective osteotomies in spine surgery","volume":"90","author":"Gill","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"R5-9-20240904","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3171\/2013.5.SPINE121067","article-title":"A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction: Clinical article","volume":"19","author":"Ames","year":"2013","journal-title":"J Neurosurg Spine"},{"key":"R6-9-20240904","doi-asserted-by":"crossref","first-page":"S171","DOI":"10.1097\/01.brs.0000231963.72810.38","article-title":"Decision making regarding Smith. 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