Zhu C, Wang LN, Chen TY, Mao LL, Yang X, Feng GJ, Liu LM, Song YM. Sequential sagittal alignment changes in the cervical spine after occipitocervical fusion. World J Clin Cases 2022; 10(4): 1172-1181 [PMID: 35211550 DOI: 10.12998/wjcc.v10.i4.1172]
Corresponding Author of This Article
Xi Yang, MD, Associate Professor, Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu 610041, Sichuan Province, China. formosa88@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2022; 10(4): 1172-1181 Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1172
Sequential sagittal alignment changes in the cervical spine after occipitocervical fusion
Ce Zhu, Lin-Nan Wang, Tai-Yong Chen, Li-Li Mao, Xi Yang, Gan-Jun Feng, Li-Min Liu, Yue-Ming Song
Ce Zhu, Lin-Nan Wang, Xi Yang, Gan-Jun Feng, Li-Min Liu, Yue-Ming Song, Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Tai-Yong Chen, Department of Orthopedics Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Li-Li Mao, Department of Ultrasound, Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Zhu C and Wang LN conceptualized and designed the study, and drafted the initial manuscript; Chen TY and Mao LL carried out the initial analyses, and reviewed and revised the manuscript; Yang X, Feng GJ, Liu LM, and Song YM coordinated and supervised the data collection, and critically reviewed and revised the manuscript for important intellectual content; Zhu C and Wang LN contributed equally to this work; all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Supported byThe Key Research and Development Project of Science & Technology Department of Sichuan Province, No. 2017SZ0046, No. 2017SZDZX0021, and No. 2021YFG0240.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of West China Hospital, Sichuan University (No. 2019762).
Informed consent statement: Written informed consent was obtained from the patients for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare they have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xi Yang, MD, Associate Professor, Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu 610041, Sichuan Province, China. formosa88@163.com
Received: September 6, 2021 Peer-review started: September 6, 2021 First decision: October 29, 2021 Revised: November 13, 2021 Accepted: December 31, 2021 Article in press: December 31, 2021 Published online: February 6, 2022 Processing time: 139 Days and 16.2 Hours
ARTICLE HIGHLIGHTS
Research background
The studies regarding sequential changes of cervical sagittal alignment (CSA) after occipitocervical fusion (OCF) were limited.
Research motivation
The comprehension of sequential changes of CSA after OCF can help surgeons prevent postoperative complications after OCF.
Research objectives
To compare the CSA of patients with craniocervical junction disorders (CJDs) with that of normal controls and investigate the sequential changes in the CSA of the upper and lower cervical spine after OCF.
Research methods
Radiographic parameters including the occipital to C2 angle (O-C2a), occipital and external acoustic meatus to axis angle (O-EAa), C2–7 angle (C2-7a), and pharyngeal inlet angle (PIA) of the selected patients were measured and compared pre- and postoperatively.
Research results
The O-C2a and PIA of the OCF group were smaller than those of the control group, while their O-EAa and C2-7a values were larger than those of the normal controls. There were significant correlations between the O-C2a and C2Ta, C2-7a, C2-7 sagittal vertical axis (SVA), and PIA at 1 mo after OCF surgery and between O-C2a and O-EAa, C2Ta, C2-7a, C2-7 SVA, and PIA at the final follow-up.
Research conclusions
Patients with CJDs have a more kyphotic upper CSA and a more lordotic lower CSA than normal controls. The effectiveness of OCF surgery in restoring CSA may be limited by the realignment of the craniocervical junction being neglected. The reduction in O-C2a after OCF surgery may increase C2-7a and decrease PIA.
Research perspectives
This study provides novel insights for sequential changes of CSA after OCF.
