Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1172
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
The studies regarding sequential changes of cervical sagittal alignment (CSA) after occipitocervical fusion (OCF) were limited.
The comprehension of sequential changes of CSA after OCF can help surgeons prevent postoperative complications after OCF.
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.
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.
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.
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.
This study provides novel insights for sequential changes of CSA after OCF.