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Cervical Sagittal Alignment: Literature Review and Future Directions

Neurospine 2020년 17권 3호 p.478 ~ 496
이상훈, 현승재, Jain Amit,
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이상훈 ( Lee Sang-Hun ) - Johns Hopkins University School of Medicine Department of Orthopaedic Surgery
현승재 ( Hyun Seung-Jae ) - Seoul National University College of Medicine Department of Neurosurgery
 ( Jain Amit ) - Johns Hopkins University School of Medicine Department of Orthopaedic Surgery

Abstract


Cervical alignment as a concept has come to the forefront for spine deformity research in the last decade. Studies on cervical sagittal alignment started from normative data, and expanded into correlation with global sagittal balance, prognosis of various conditions, outcomes of surgery, definition and classification of cervical deformity, and prediction of targets for ideal cervical reconstruction. Despite the recent robust research efforts, the definition of normal cervical sagittal alignment and cervical spine deformity continues to elude us. Further, many studies continue to view cervical alignment as a continuation of thoracolumbar deformity and do not take into account biomechanical features unique to the cervical spine that may influence cervical alignment, such as the importance of musculature connecting cranium-cervical-thoracic spine and upper extremities. In this article, we aim to summarize the relevant literature on cervical sagittal alignment, discuss key results, and list potential future direction for research using the ‘5W1H’ framework; “WHO” are related?, “WHY” important?, “WHAT” to evaluate and “WHAT” is normal?, “HOW” to evaluate?, “WHEN” to apply sagittal balance?, and “WHERE” to go in the future?

키워드

Cervical alignment; Cervical sagittal balance; Cervical kyphosis; Cervical deformity; Cervical lordosis; Neck tilt

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