Cervical Spine Deformity

Indications, Considerations, and Surgical Outcomes

Samuel K. Cho, MD; Scott Safir, MD; Joseph M. Lombardi, MD; Jun S. Kim, MD

Disclosures

J Am Acad Orthop Surg. 2019;27(12):e555-e567. 

In This Article

Abstract and Introduction

Abstract

Cervical spinal deformity (CSD) in adult patients is a relatively uncommon yet debilitating condition with diverse etiologies and clinical manifestations. Similar to thoracolumbar deformity, CSD can be broadly divided into scoliosis and kyphosis. Severe forms of CSD can lead to pain; neurologic deterioration, including myelopathy; and cervical spine–specific symptoms such as difficulty with horizontal gaze, dysphagia, and dyspnea. Recently, an increased interest is shown in systematically studying CSD with introduction of classification schemes and treatment algorithms. Both major and minor complications after surgical intervention have been analyzed and juxtaposed to patient-reported outcomes. An ongoing effort exists to better understand the relationship between cervical and thoracolumbar spinal alignment, most importantly in the sagittal plane.

Introduction

Cervical spinal deformity (CSD) remains a moving target in the current spine literature. It is a potentially debilitating condition with numerous etiologies, such as iatrogenic, inflammatory arthropathy, spondylosis, congenital, neuromuscular, traumatic, infectious, and neuromuscular processes. Severe cervical instability or sagittal malalignment can lead to pain; neurologic deterioration, including myelopathy; and cervical spine (CS)–specific symptoms such as difficulty with horizontal gaze, dysphagia, and dyspnea. Recent efforts have sought to classify CSD and formulate treatment algorithms. In this review, we discuss the anatomy, pathophysiology, and common etiologies of CSD. We then describe possible treatments, which are as myriad as the etiologies of CSD. Finally, we discuss the outcomes of CSD in the literature and its relationship to thoracolumbar deformity (TLD).

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