Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by The 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
Core Tip

Core Tip: Patients with craniocervical junction disorders had a more kyphotic upper cervical sagittal alignment (CSA) and a more lordotic lower CSA than normal controls: The decreased lordosis of the upper cervical spine caused by the weakness of paraspinal muscles and ligaments (OC2a↓) led to the gravity center of the cranium moving forward (C2Ta↑). To maintain horizontal gaze and normal C2-7 sagittal vertical axis, the lordosis of the lower cervical spine was increased (C2-7a↑). Moreover, the restoration of CSA after occipitocervical fusion (OCF) may be limited by neglecting the realignment of craniocervical junction. The reduction of the O-C2a after OCF would increase the C2-7a and decrease the pharyngeal inlet angle and lead to postoperative dysphagia.