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Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review

Neurospine 2020년 17권 3호 p.497 ~ 504
김창욱, 현승재, 김기정,
소속 상세정보
김창욱 ( Kim Chang-Wook ) - Seoul National University Bundang Hospital Department of Neurosurgery
현승재 ( Hyun Seung-Jae ) - Seoul National University Bundang Hospital Department of Neurosurgery
김기정 ( Kim Ki-Jeong ) - Seoul National University Bundang Hospital Department of Neurosurgery

Abstract


When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. These compensations occur through mobile spine segments as well as pelvic tilt and lower extremities. The purpose of this review was to understand the surgical impact on global sagittal alignment and health-related quality of life (HRQoL) following cervical kyphosis correction surgery. The cervical kyphosis correction surgery induces reciprocal changes in craniocervical and thoracolumbar alignment. Successful cervical deformity correction needs to focus not only on restoring proper cervical lordosis, but also on achieving global balance of the cervical spine with other parts of the spine. The goal of the surgery is to achieve occiputtrunk (OT) concordance (the center of gravity-C7 sagittal vertical axis < 30 mm) and cervical sagittal balance. Once OT-concordance is achieved, subsequent thoracolumbar alignment changes occur as needed to harmonize global spinal alignment. Reciprocal changes after surgery exhibit different patterns depending on whether patients have compensation ability in their thoracolumbar spine or not. C2?7 sagittal vertical axis and sagittal morphotype of the cervical kyphosis are correlated with HRQoL. Changes in cervical lordosis minus T1 slope correlate to HRQoL improvements.

키워드

Cervical reconstruction; Global sagittal alignment; Reciprocal change; Health-related quality of life

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