Development of new-onset cervical deformity in nonoperative adult spinal deformity patients with 2-year follow-up

INTERNATIONAL SPINE STUDY GROUP (ISSG)

Research output: Contribution to journalReview article

Abstract

Purpose: Evaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes. Methods: Retrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors. Results: A total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m 2 , 86% female). Cervical deformity rate was 38.5% at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0% and 41.7%, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P . .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P ¼ .025) and 2 years (OR 1.04, P ¼ .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P ¼ .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P ¼ .041). CD development did not significantly impact health-related quality of life (P . .05). Conclusions: Cervical deformity can manifest in nonoperative ASD patients: 30.0% at 1-year follow-up, and 41.7% at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.

Original languageEnglish (US)
Pages (from-to)725-734
Number of pages10
JournalInternational Journal of Spine Surgery
Volume12
Issue number6
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Odds Ratio
Logistic Models
History
Spine
Body Mass Index
Quality of Life
Incidence

Keywords

  • Adult spinal deformity
  • Cervical deformity
  • New-onset cervical deformity
  • Nonoperative

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Development of new-onset cervical deformity in nonoperative adult spinal deformity patients with 2-year follow-up. / INTERNATIONAL SPINE STUDY GROUP (ISSG).

In: International Journal of Spine Surgery, Vol. 12, No. 6, 01.12.2018, p. 725-734.

Research output: Contribution to journalReview article

@article{96e712a8832f4450aee031e232937c13,
title = "Development of new-onset cervical deformity in nonoperative adult spinal deformity patients with 2-year follow-up",
abstract = "Purpose: Evaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes. Methods: Retrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors. Results: A total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m 2 , 86{\%} female). Cervical deformity rate was 38.5{\%} at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0{\%} and 41.7{\%}, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P . .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P ¼ .025) and 2 years (OR 1.04, P ¼ .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P ¼ .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P ¼ .041). CD development did not significantly impact health-related quality of life (P . .05). Conclusions: Cervical deformity can manifest in nonoperative ASD patients: 30.0{\%} at 1-year follow-up, and 41.7{\%} at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.",
keywords = "Adult spinal deformity, Cervical deformity, New-onset cervical deformity, Nonoperative",
author = "{INTERNATIONAL SPINE STUDY GROUP (ISSG)} and Passias, {Peter G.} and Jalai, {Cyrus M.} and Nancy Worley and Shaleen Vira and Scheer, {Justin K.} and Smith, {Justin S.} and Subaraman Ramachandran and Alexandra Soroceanu and Horn, {Samantha R.} and Poorman, {Gregory W.} and Protopsaltis, {Themistocles S.} and Klineberg, {Eric O.} and Sciubba, {Daniel M.} and Kim, {Han Jo} and {Kojo Hamilton}, D. and Renaud Lafage and Virginie Lafage and Ames, {Christopher P.}",
year = "2018",
month = "12",
day = "1",
doi = "10.14444/5091",
language = "English (US)",
volume = "12",
pages = "725--734",
journal = "International Journal of Spine Surgery",
issn = "2211-4599",
publisher = "Elsevier USA",
number = "6",

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TY - JOUR

T1 - Development of new-onset cervical deformity in nonoperative adult spinal deformity patients with 2-year follow-up

AU - INTERNATIONAL SPINE STUDY GROUP (ISSG)

AU - Passias, Peter G.

AU - Jalai, Cyrus M.

AU - Worley, Nancy

AU - Vira, Shaleen

AU - Scheer, Justin K.

AU - Smith, Justin S.

AU - Ramachandran, Subaraman

AU - Soroceanu, Alexandra

AU - Horn, Samantha R.

AU - Poorman, Gregory W.

AU - Protopsaltis, Themistocles S.

AU - Klineberg, Eric O.

AU - Sciubba, Daniel M.

AU - Kim, Han Jo

AU - Kojo Hamilton, D.

AU - Lafage, Renaud

AU - Lafage, Virginie

AU - Ames, Christopher P.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Purpose: Evaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes. Methods: Retrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors. Results: A total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m 2 , 86% female). Cervical deformity rate was 38.5% at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0% and 41.7%, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P . .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P ¼ .025) and 2 years (OR 1.04, P ¼ .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P ¼ .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P ¼ .041). CD development did not significantly impact health-related quality of life (P . .05). Conclusions: Cervical deformity can manifest in nonoperative ASD patients: 30.0% at 1-year follow-up, and 41.7% at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.

AB - Purpose: Evaluate the presence of new-onset cervical deformity (CD) in nonoperative adult spinal deformity (ASD) patients with extended follow-up, with consideration for predictors, prevalence, and impact on patient-reported outcomes. Methods: Retrospective review of a prospective nonoperative ASD cohort. New onset CD patients at 1- (CD-1Y) and 2-year (CD-2Y) follow-up were defined as displaying baseline cervical alignment. Univariate analyses determined differences in radiographic parameters and outcome scores of CD and maintained-cervical-alignment patients. Multivariate binary logistic regression models determined new-onset CD predictors. Results: A total of 143 patients were included (mean age 54 years, mean body mass index 25.6 kg/m 2 , 86% female). Cervical deformity rate was 38.5% at baseline. New-onset CD incidence at 1- and 2-year follow-up was 30.0% and 41.7%, respectively. Global sagittal profile comparison of CD-1Y/CD-2Y versus maintained cervical alignment cases revealed no differences (P . .05) at any interval. Baseline C2-C7 sagittal vertical axis (SVA) was associated with increased new-onset CD risk at 1 (odds ratio [OR] 1.14, P ¼ .025) and 2 years (OR 1.04, P ¼ .032); prior spine surgical history was associated with CD risk at 1-year follow-up (OR 6.75, P ¼ .047); baseline C2 slope was associated with increased CD risk at 2-year follow-up (OR 1.12, P ¼ .041). CD development did not significantly impact health-related quality of life (P . .05). Conclusions: Cervical deformity can manifest in nonoperative ASD patients: 30.0% at 1-year follow-up, and 41.7% at 2-year follow-up. Progressive CD manifested independently of thoracolumbar profile changes. Increased baseline C2-C7 SVA, C2 slope, and prior surgical history increased new-onset CD odds at 1 and 2 years.

KW - Adult spinal deformity

KW - Cervical deformity

KW - New-onset cervical deformity

KW - Nonoperative

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U2 - 10.14444/5091

DO - 10.14444/5091

M3 - Review article

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AN - SCOPUS:85059563632

VL - 12

SP - 725

EP - 734

JO - International Journal of Spine Surgery

JF - International Journal of Spine Surgery

SN - 2211-4599

IS - 6

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