Clinical Spine Surgery最新文献

{"title":"A Narrative Review of the Cervical Spine Deformity Classification Systems.","authors":"Paxton Gehling, David Mazur-Hart, Jason Savage, Justin S Smith, Greg Schroeder, Alexander Butler, Bayard Carlson, Srikanth Divi, Andrew Hecht, Christopher Kepler, Safdar Khan, Michael Stauff, Won Hyung A Ryu","doi":"10.1097/BSD.0000000000001933","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001933","url":null,"abstract":"<p><strong>Objectives: </strong>This paper reviews several recent cervical spine deformity classifications with the goal of contextualizing these efforts, and providing a overview of the subject to date.</p><p><strong>Summary of background data: </strong>Cervical spine deformity is a complex and heterogenous disorder encompassing pathology from the craniocervical junction to the cervicothoracic junction. It can arise from focal pathology, regional or global malalignment and can convey significant functional impairment and morbidity, and surgical management can represent a technical and conceptual challenge. In the last 15 years multiple classification systems have been published to aid in clinical communication and guide treatments.</p><p><strong>Methods: </strong>A PubMed search was performed to identify publications on cervical spine deformity classifications.</p><p><strong>Results: </strong>Five classification schemes were identified and reviewed in this publication. Particular care was taken to contextualize them with regards to clinical suitability.</p><p><strong>Conclusion: </strong>Cervical deformity classifications continue to evolve, mirroring advances in understanding of pathophysiology, etiology, and clinical management of this heterogenous disorder.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Levels of Hemoglobin A1C are Not Associated With Increased Complication Rates After Anterior Cervical Discectomy and Fusion.","authors":"Melissa Baker, Rudy Zambrano, Eloise W Stanton, Nima Saboori, Anastasia Artemiev, Joseph Pyun, Michael C Gerling, Zorica Buser","doi":"10.1097/BSD.0000000000001856","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001856","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To assess the relationship between preoperative HbA1c and postoperative complications up to 180 days in prediabetic and diabetic patients undergoing anterior cervical discectomy and fusion.</p><p><strong>Summary of background data: </strong>Diabetes mellitus has been associated with an increased complication rate and poor postoperative outcomes in patients undergoing elective spine surgeries, but few publications have fully analyzed the effect of preoperative HbA1c on postoperative complications in the cervical spine.</p><p><strong>Methods: </strong>Patients diagnosed with prediabetes or diabetes who underwent anterior cervical discectomy and fusion between 2018 and 2022. Patients were categorized based on their preoperative HbA1c levels: category I with HbA1c levels from 5% to 6.5%, category II from 6.6% to 8%, and category III>8%. Demographics, preoperative glucose and HbA1c levels, and postoperative complications were collected. Postoperative complications were categorized as revision, dysphagia, wound, and other. Pearson χ2 tests and regression models/analyses were used.</p><p><strong>Results: </strong>The current study included 75 patients. Within 30 days postoperatively, there was 1 patient in category I, 1 in category II, and 2 in category III with documented complications. At 31-90 days, only 1 patient in category III reported a complication. There were no complications 91-180 days postoperatively. There was no statistically significant difference in complication or revision rates among the categories at all postoperative time intervals.</p><p><strong>Conclusions: </strong>In the current study, no statistically significant difference was found between elevated HbA1c level and complication rates between diabetics categorized by HbA1c levels at all postoperative time intervals. Future studies are necessary to develop a multifactorial approach to medical clearance in diabetic patients that qualify for cervical spine surgeries.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips and Tricks: Fixation Options in the Osteoporotic Cervical Spine.","authors":"Mohit Patel, Sang H Lee","doi":"10.1097/BSD.0000000000001898","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001898","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To outline current fixation strategies and adjunctive techniques used to optimize surgical outcomes in patients with osteoporosis undergoing cervical spine surgery.</p><p><strong>Summary of background data: </strong>Osteoporosis, a common metabolic bone disorder characterized by low bone mineral density and high fracture risk, can impair the outcomes of cervical spine surgery. In patients with osteoporosis, durable fixation is challenging to achieve because of compromised bone quality and anatomic constraints. While lumbar spine fixation techniques have been extensively studied and adapted, the cervical spine presents unique obstacles that warrant consideration.</p><p><strong>Methods: </strong>A review of clinical series, biomechanical studies, and surgical techniques was conducted to summarize intraoperative strategies for cervical fixation in patients with osteoporosis.</p><p><strong>Results: </strong>Optimization of screw fixation, creation of an ancillary load sharing column, cement augmentation, and perioperative management of osteoporosis can improve patient outcomes.</p><p><strong>Conclusions: </strong>A combination of intraoperative techniques and pharmacological treatment is critical in the management of patients with osteoporosis who are undergoing cervical spine fixation.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considering the Effects of Age and Patient Factors on Subsidence and Implant Selection in Anterior Cervical Discectomy and Fusion: A Retrospective Cohort Study of 261 Patients.","authors":"Jeffrey B Weinreb, Jake Carbone, Hershil Patel, Amit Ratanpal, Rohan I Suresh, Tyler J Pease, Ryan A Smith, Joseph Blommer, Anthony K Chiu, Idris Amin, Louis J Bivona, Julio J Jauregui, Daniel L Cavanaugh, Eugene Y Koh, Charles A Sansur, Steven C Ludwig","doi":"10.1097/BSD.0000000000001921","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001921","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The purpose of this study is to assess the relative safety and efficacy of anterior cervical discectomy and fusion (ACDF) procedures and evaluate factors of concern among these patients. We hypothesized that patient age would be predictive of subsidence and all-cause revision.</p><p><strong>Summary of background data: </strong>ACDF improves cervical alignment and patient outcomes. Although ACDF has a long record of safety and efficacy, revisions remain commonplace, particularly in multilevel fusions. Surgeons and patients would benefit from a greater ability to stratify patients and techniques preoperatively to reduce complications and reoperations.</p><p><strong>Patients and methods: </strong>A retrospective chart review, over 10 years, of all patients over the age of 18 with neck pain and radiculopathy treated with ACDF, at operative levels C3-C7, was performed. Patients must have immediate postoperative and 6-month follow-up imaging. Exclusion criteria were operative levels C7-T1, trauma, infection, pathology, and a history of previous cervical spine surgery.</p><p><strong>Results: </strong>In total, 261 patients were included in the final analysis. Radiographically, when compared with white patients, black patients had lower rates of fusion (P<0.001) and greater rates of pseudarthrosis (P=0.013) at 6-month follow-up. The use of titanium cages was significantly predictive of reduced subsidence when compared with the allograft (P=0.029). Greater age was associated with reduced rates of subsidence (P=0.036). When adjusted for race, BMI, and sex, initial height and age were not predictive of revision. Polyetheretherketone (PEEK) implants saw significantly greater rates of revision (P=0.009).</p><p><strong>Conclusions: </strong>When adjusted for spacer material and number of fused levels, age is not independently predictive of pseudarthrosis, revision, or change in segmental height. Regardless of loss of segmental height, the choice of implant material may not significantly affect reoperation. Differences in rates of fusion and pseudarthrosis in black patients may be temporary; however, surgeons should consider careful monitoring of these patients to avoid unnecessary revisions.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Postoperative Outcomes of Surgical Treatment for Spinal Metastasis Differ by Institutional Function?: Analysis of a Nationwide Administrative Database in Japan.","authors":"Kentaro Yamada, Mikayo Toba, Hiroyuki Sato, Satoru Egawa, Shingo Morishita, Yu Matsukura, Takashi Hirai, Akihiro Hirakawa, Atsushi Kudo, Kiyohide Fushimi, Toshitaka Yoshii","doi":"10.1097/BSD.0000000000001885","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001885","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective comparative study.</p><p><strong>Objective: </strong>To investigate the impact of institutional function (cancer center and surgical volume for spine surgery) on in-hospital outcomes after surgical treatment for spinal metastasis using a nationwide administrative database.</p><p><strong>Summary of background data: </strong>Multidisciplinary approaches to bone metastasis have become common in Japan, especially in cancer centers. However, whether treatment outcomes for spinal metastasis surgery differ by institutional function remains controversial.</p><p><strong>Methods: </strong>Data of patients who underwent surgical procedures for spinal metastasis between 2012 and 2020 were extracted from the Diagnosis Procedure Combination database. In-hospital outcomes included in-hospital mortality, 30-day mortality, length of stay until discharge home, postoperative complications, and unfavorable ambulatory status. Univariate and multivariate analyses were performed to investigate the association between cancer center/surgical volume and each outcome while adjusting for potential confounders.</p><p><strong>Results: </strong>A total of 10,320 patients were included in this study. Among them, 5261 patients were treated at cancer centers. The median annual surgical volume for spine surgery was 166 cases. The 30-day mortality was lower in cancer centers than in noncancer centers [odds ratio (OR): 0.841, 95% CI: 0.709-0.999, P=0.0483] and in high-volume hospitals for spine surgery than in low-volume hospitals (OR per 50 cases: 0.958, 95% CI: 0.928-0.990, P=0.0101). The length of stay until discharge home, postoperative complications, and postoperative unfavorable ambulatory status did not differ by cancer center or surgical volume.</p><p><strong>Conclusion: </strong>The short-term mortality was lower in cancer centers or high-volume hospitals, whereas postoperative complications and ambulatory outcomes did not differ by institutional function. A deeper understanding of the multidisciplinary approaches or processes of care adopted at these institutions might be important to deliver similar outcomes in other hospitals to patients with spinal metastasis.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Preoperative SF-36 and Postoperative Axial Neck Pain in Patients With Cervical Spondylotic Myelopathy After Anterior Decompressive Surgery.","authors":"Rui Chen, Jiesheng Liu, Yanbin Zhao, Yinze Diao, Xin Chen, Shengfa Pan, Fengshan Zhang, Yu Sun, Feifei Zhou","doi":"10.1097/BSD.0000000000001916","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001916","url":null,"abstract":"<p><strong>Study design: </strong>A single-center retrospective study.</p><p><strong>Objective: </strong>This study investigates the correlation between preoperative SF-36 scores and postoperative axial neck pain (ANP) in cervical spondylotic myelopathy (CSM) patients undergoing anterior cervical surgery (ACS).</p><p><strong>Summary of background data: </strong>The effects of the anterior surgical approach on ANP are not well understood.</p><p><strong>Methods: </strong>This retrospective study included patients with CSM at Peking University Third Hospital between April 2010 and March 2016. The SF-36, visual analog scale (VAS), and Neck Disability Index (NDI) were collected preoperatively and postoperatively at 3 months, 1 year, and 2 years.</p><p><strong>Results: </strong>In 107 CSM patients, ACS significantly improved pain, physical function, and quality of life over 2 years. VAS scores decreased from 6.4±2.3 to 3.8±1.9, indicating less ANP (P=0.013). SF-36 scores improved notably in social functioning and bodily pain domains. NDI scores also decreased, showing reduced neck disability (P=0.012). Patients with ANP post-ACS had consistently lower preoperative bodily pain and social functioning scores at follow-up of 3 timepoints. Correlation analysis revealed a significant negative relationship between VAS and preoperative bodily pain and social functioning scores (P<0.05), suggesting that lower preoperative scores may predict severe postoperative ANP.</p><p><strong>Conclusions: </strong>Anterior cervical surgery does not increase the incidence of postoperative ANP in patients with CSM. The BP and SF domains of the preoperative SF-36 are correlated with the occurrence of postoperative ANP.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinicopathologic Spectrum and Management of Primary Intradural and Dumbbell Spinal Tumors: Our Experience in a Nigerian Teaching Hospital.","authors":"Komolafe O Edward, Christopher O Anele, Balogun S Adewale, Chizowa O Ezeaku","doi":"10.1097/BSD.0000000000001906","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001906","url":null,"abstract":"<p><strong>Background: </strong>Primary intradural and dumbbell spinal tumours, are most commonly found in the thoracic region. The presentation, diagnosis, and management are at times challenging. The primary treatment of choice is surgical resection; however, this could be challenging in resource-limited settings, especially for intramedullary tumours.</p><p><strong>Methodology: </strong>A retrospective study of patients with primary intradural and dumbbell spinal tumours. The age, sex, and clinical presentation, duration of symptoms, spinal region, anatomic classification, the extent of resection, histology, and outcome of these patients were assessed, analysed, and presented.</p><p><strong>Results: </strong>There were 31 patients comprising of 17 females and 14 males, respectively. The age range was 11 months to 76 years (mean age of 39.3 y). The thoracic spine was the most commonly affected (20 patients, 64.5%). The most common initial presenting complaints were: limb weakness/paralysis (87.5%) for the intramedullary group, axial pain (88.9%) for the intradural extramedullary group, and nonradicular pain (60%) for the dumbbell group.</p><p><strong>Conclusion: </strong>Primary intradural and dumbbell spinal tumours are mostly benign or low-grade tumours and are commonly found in the thoracic spine. They are individually unique with respect to their diverse clinical presentations and peculiar histologic types. These eventually determine their treatment outcomes and quality of life.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Radiographic Parameters in Cervical Deformity.","authors":"Max Fisher, Oluwatobi O Onafowokan, Kyriakos Chatzis, Peter Tretiakov, Peter G Passias","doi":"10.1097/BSD.0000000000001897","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001897","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To synthesize current knowledge on radiographic parameters, classification systems, and compensatory mechanisms essential to the diagnosis and surgical planning of cervical spine deformity (CD) correction.</p><p><strong>Summary of background data: </strong>CD encompasses a heterogeneous set of conditions associated with neurological impairment and impaired health-related quality of life. Surgical outcomes are closely linked to radiographic alignment, yet no framework exists that integrates all relevant metrics.</p><p><strong>Methods: </strong>This review evaluates contemporary literature to outline major cervical and global alignment parameters, classification systems, and compensatory mechanisms relevant to surgical planning.</p><p><strong>Results: </strong>Key parameters such as T1S-CL mismatch and cSVA remain essential for assessing sagittal imbalance in CD. However, cervical alignment is often influenced by global compensation, highlighting the need for full-spine evaluation. Classification systems offer structured, outcome-driven frameworks, while morphologic subtypes further guide surgical approach. Despite these tools, revision rates remain relatively high. Emerging metrics, such as upper cervical extension reserve (UER), may offer additional insight into patient-specific alignment capacity, serving as valuable adjuncts to better predict outcomes.</p><p><strong>Conclusions: </strong>Optimal surgical planning in CD requires a comprehensive approach that integrates regional and global alignment parameters, individualized modifiers, and morphologic considerations. Incorporating emerging metrics may improve long-term clinical outcomes.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Management of Inpatients With Ossified Posterior Longitudinal Ligament (OPLL): A 10-year Tertiary Center UK Study.","authors":"Masna Inam, Anthony Roylance, Ali Bakhsh, Maggie Lee, Simon Clark, Martin J Wilby","doi":"10.1097/BSD.0000000000001908","DOIUrl":"10.1097/BSD.0000000000001908","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To characterise patients admitted to a UK tertiary centre with OPLL over a 10-year period.</p><p><strong>Summary of background data: </strong>OPLL is a progressive degenerative condition that can lead to myelopathy. Incidence of OPLL is increasing in Caucasian populations due to increased alcohol consumption, smoking, increased body mass, reduced exercise, and glucose intolerance. This questions the traditional belief that Ossification of the Posterior Longitudinal Ligament (OPLL) is primarily a disease of East and South-East Asians.</p><p><strong>Methods: </strong>A retrospective review was performed for all OPLL cases admitted to one of the UK's largest spinal neurosurgery units between 2011 and 2021. Imaging, operation notes, clinic letters, and inpatient records were interrogated. The data for conservatively and surgically managed patients were collected. Demographics, surgical methods, complications, and recovery data are presented and analysed using univariate analysis.</p><p><strong>Results: </strong>One hundred eighty-three patients were included, of whom 66% were male with a median age of 60 years. The majority of OPLL affected C2-5, with 2-level involvement being the most common. Eighty-six patients (47%) underwent surgical intervention, of which posterior decompression alone (35%) was the most common procedure. Fourteen (16.2%) patients developed complications, of which 4 were suspected reperfusion injuries, 6 with wound issues and 1 death. Eighty-seven percent of patients identified as White Caucasian. Importantly, data on smoking status were retrieved in only 18% of patients, precluding risk factor analysis for OPLL.</p><p><strong>Conclusions: </strong>OPLL is a heterogeneous disease that is treated based on patient and disease-specific parameters in the inpatient population. High degrees of social deprivation in our catchment area may be more prominent risk factors than the known ethnic risk group factors. Dedicated research on risk factor identification and human tissue is needed to identify aetiology and novel therapeutic targets.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Treatment Algorithm for the Management of Cervical Deformity, or Developing an Algorithm for the Treatment of Cervical Deformity.","authors":"Luis Felipe Colón, Eric Zhao, Han Jo Kim","doi":"10.1097/BSD.0000000000001899","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001899","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>Summarize current classification systems, preoperative considerations, surgical approaches, and outcomes in patients with cervical deformity.</p><p><strong>Summary of background data: </strong>Cervical deformity (CD) is a complex pathology with varying presentations. Surgical management of CD is debated, in part due to uncertainty in CD classifications. This review summarizes the current knowledge on CD classification, management, and postoperative outcomes.</p><p><strong>Methods: </strong>Review of literature on CD.</p><p><strong>Results: </strong>Two major classification systems for CD currently exist. The earlier Ames system is limited in clinical applicability due to complexity and extensive imaging requirements, while the Kim system is simpler, based on patient-reported outcomes, and utilizes dynamic imaging, which assists with surgical level selection. CD treatment necessitates a thorough understanding of patient medical and surgical history, physical examination, and analysis of static and dynamic preoperative imaging. Long-term treatment of CD requires surgical intervention, performed through anterior, posterior, or combined approaches, involving fusions and/or decompressions, various osteotomies, and corpectomies. Despite substantial complication rates, patients often experience significant improvements in pain and functionality after surgery.</p><p><strong>Conclusions: </strong>CD involves complex and varying patient presentations, pathology subtypes, and surgical treatment options. Optimizing patient outcomes requires tailored surgical management and a thorough understanding of patient pathology and presentation.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}