A Comparison of Three Different Positioning Techniques on Surgical Corrections and Postoperative Alignment in Cervical Spinal Deformity (CD) Surgery

Kyle W. Morse, MD; Renaud Lafage, MS; Peter Passias, MD; Christopher P. Ames, MD; Robert Hart, MD; Christopher I. Shaffrey, MD; Gregory Mundis, MD; Themistocles Protopsaltis, MD; Munish Gupta, MD; Eric Klineberg, MD; Doug Burton, MD; Virginie Lafage, PhD; Han Jo. Kim, MD


Spine. 2021;46(9):567-570. 

In This Article

Materials and Methods

Study Design

A multicenter retrospective analysis of a CD database (2013–2016) that utilized preoperative and postoperative lateral radiographs in patients at least 18 years of age undergoing surgical correction above the C6 level was performed. Inclusion criteria included at least one of the radiographic and additional criteria listed in Table 1. Patients were excluded if they underwent Grade 5, 6, or 7 osteotomies.[1]

Patients and Data Collection

Eighty patients were included in the study. Patient demographic and surgical data are listed in Table 2. Preoperative and postoperative radiographs were reviewed and C2–C7, C2–C7 sagittal vertical axis (cSVA), cervical scoliosis, T1 slope minus cervical lordosis (TS–CL), T1 slope (T1S), chin-brow vertebral angle (CBVA), C2–T3 curve, and C2–T3 SVA were recorded.


All data analysis was performed using SPSS Version 20.0 (International Business Machines [IBM], Armonk, NY). Statistical tests were utilized as displayed in Table 3. Alignment was compared between positioning groups and segmental alignment was analyzed using the Fergusson method.[2,3] Segmental correction between C2 and T5 was analyzed and Pearson correlations were performed to determine a relationship between the number of levels fused and segmental correction. Statistical significance was defined as α = 0.05.