{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:32:33Z","timestamp":1786739553047,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Correction of rigid cervicothoracic sagittal imbalance is technically demanding, especially in patients with prior cervical fusion or ankylosing spondylitis. Three-column osteotomies at C6\u2013T1 can achieve deformity correction but carry risks of vertebral artery and cervical nerve root injury. T2 pedicle subtraction osteotomy (PSO) may provide comparable correction with a more favorable neurovascular risk profile. We evaluated radiographic outcomes, durability of correction, and safety of T2 PSO for rigid cervicothoracic deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Nineteen consecutive patients who underwent T2 PSO (2017\u20132025) were retrospectively reviewed. Radiographic parameters, including C2\u2013C7 sagittal vertical axis (SVA), C2\u2013S1 SVA, T1 slope (TS), TS\u2013CL mismatch, and C6\u2013T4 cervicothoracic angle (CTA), were assessed preoperatively, immediately postoperatively, and at last follow-up. Complications and reoperations were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean C2\u2013C7 SVA improved from 65.5 mm to 40.1 mm postoperatively (\u221225.4 mm, P &lt; 0.001) and remained improved at 46.5 mm at final follow-up (P = 0.005). C2\u2013S1 SVA decreased by 30.8 mm (P = 0.008). TS improved from 47.3\u00b0 to 31.2\u00b0 (\u221216.1\u00b0, P &lt; 0.001), TS\u2013CL mismatch by 12.9\u00b0 (P &lt; 0.001), and CTA from 16.7\u00b0 to 5.2\u00b0 (\u221211.5\u00b0, P = 0.002). Radiographic gains were largely maintained at a mean 11.6-month follow-up. Complications occurred in 47.4%; one transient neurologic deficit occurred, with no permanent spinal cord, nerve root, or vascular injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>T2 PSO provides substantial and durable correction of cervicothoracic sagittal imbalance with a favorable neurovascular safety profile, particularly in patients with prior cervical fusion or ankylosing spondylitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_52_26","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:00:14Z","timestamp":1779267614000},"page":"326-333","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Role of T2 pedicle subtraction osteotomy in rigid cervicothoracic sagittal imbalance correction: A case series with technical details"],"prefix":"10.4103","volume":"17","author":[{"given":"Mohsen","family":"Rostami","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayard R.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Wolfson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadegh","family":"Bagherzadeh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent C.","family":"Traynelis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo B. 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