Evolution of Adult Cervical Deformity Surgery Clinical and Radiographic Outcomes Based on a Multicenter Prospective Study: Are Behaviors and Outcomes Changing with Experience?

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Spine (Phila Pa 1976)


washington; seattle; swedish neurosci


STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: Assess changes in outcomes and surgical approaches for adult cervical deformity (ACD) surgery over time.

SUMMARY OF BACKGROUND DATA: As the population ages and prevalence of cervical deformity increases, corrective surgery has been increasingly seen as a viable treatment. Dramatic surgical advancements and expansion of knowledge on this procedure have transpired over years, but the impact on cervical deformity surgery is unknown.

METHODS: ACD patients (≥18 yrs) with complete baseline and up to two-year HRQL and radiographic data were included. Descriptive analysis included demographics, radiographic, and surgical details. Patients were grouped into Early(2013-2014) and Late(2015-2017) by DOS. Univariate and multivariable regression analyses were used to assess differences in surgical, radiographic, and clinical outcomes over time.

RESULTS: 119 cervical deformity patients met inclusion criteria. Early group consisted of 72 patients, and Late group consisted of 47. Late group had a higher CCI (1.3 vs. 0.72), more cerebrovascular disease (6% vs. 0%, both P

CONCLUSION: Despite a population with greater co-morbidity and associated risk, outcomes remained consistent between early and later time-periods, indicating general improvements in care. The later cohort demonstrated fewer three-column osteotomies, less suboptimal realignments and concomitant reductions in adverse events and neurologic complications. This may suggest greater facility with less invasive techniques.

Clinical Institute

Neurosciences (Brain & Spine)

Clinical Institute

Orthopedics & Sports Medicine