Surgical strategies for treatment of secondary cervical subaxial spine kyphotic deformities (review)
https://doi.org/10.56618/2071-2693_2024_16_2_174
EDN: JPLQCZ
Abstract
Cervical subaxial kyphotic deformity is a socially significant problem, leading to a decrease in the quality of life, up to complete disability. This article highlights modern methods of subaxial deformity surgery, their advantages and disadvantages.
Aim is analysis of treatment option using in cervical spine deformity surgery, based on the literature data.
117 literature sources were analyzed from 2004 to 2023 PubMed and Google Scholar databases were used as resources using queries on medical topics for the terms “cervical spine deformity”, “cervical kyphosis surgery”, “cervical spine sagittal balance”. We used 27 articles that are most suitable for search criteria published in English and Russian. There were no evidence level restrictions. The issues of pathogenesis, clinical picture, methods of assessing the sagittal profile of the cervical spine, as well as various methods of surgical treatment and their complications are highlighted.
Choosing the optimal treatment tactics can be difficult and often contradictory due to the large number of complications, both anesthetic and surgical. Therefore, the design of the surgical option should be based on deformity severity, its type, clinical presentation, as well as the individual characteristics of the patient.
Supporting agencies: The study was performed without external funding. The work was carried out within the framework of a state assignment 122041900091-1
About the Authors
D. V. Biragov
National Medical Research Center for Traumatology and Orthopedics named after R. R. Vreden; V. A. Almazov National Medical Research Center
Russian Federation
Russian Federation
David V. Biragov – Neurosurgeon
2 Akkuratova street, St. Petersburg, 197341
D. A. Gulyaev
V. A. Almazov National Medical Research Center
Russian Federation
Russian Federation
Dmitry A. Gulyaev – Dr. of Sci. (Med.), Associate Professor, Head at the Laboratory of Integrative Neurosurgical Technologies
8 Academician Baykova street, St. Petersburg, 195427
2 Akkuratova street, St. Petersburg, 197341
D. S. Godanyuk
V. A. Almazov National Medical Research Center
Russian Federation
Russian Federation
Denis S. Godanyuk – Neurosurgeon at the Department of Neurosurgery No. 5
2 Akkuratova street, St. Petersburg, 197341
References
1. . Shuang A., Liu Y., Wang Y. et al. Cervical kyphosis in asymptomatic populations: incidence, risk factors, and its relationship with health-related quality of life. J Orthop Surg Res. 2019;14(1):322. Doi: 10.1186/s13018-019-1351-2.
2. Damdinov B. B., Sorokovikov V. A., Larionov S. N. et al. Peculiarities of changes in the sagittal balance of the cervical spine in cervicobrachial syndrome. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2019;16(2):42–48. (In Russ.)]. Doi: 10.14531/ss2019.2.42-48. EDN: BWYTYM.
3. Schneider L. S., Pavlov V. V., Krutko A. V. Changes in the vertebral-pelvic balance after hip replacement in patients with congenital hip dislocation. Spine surgery. 2018;15(4):80–86. (In Russ.)]. Doi: 10.14531/2018.4.80-86. EDN: YZKXXN.
4. Makirov S. K., Yuz A. A., Jahhaf M. T. Methodology for assessing sagittal vertebral-pelvic balance. Journal of Spine Surgery. 2015;12(3):55–63. (In Russ.)]. Doi: 10.14531/ss2015.3.55-63. EDN: UMGWQX.
5. Borzykh K. O., Roerich V. V., Samokhin A. G. Parameters of sagittal balance in patients with posttraumatic deformities of the lower thoracic and upper lumbar localization. Modern problems of science and education. 2018;(6). (In Russ.). Available from: https://science-education.ru/ru/article/view?id=28266 [Accessed 18 March 2024]]. EDN: YVMKLZ.
6. Protsenko A. I., Nikuradze V. K., Mekhtikhanov D. S. Surgical tactics in the treatment of cervical spine injury. Surgery: Magazine named after N. I. Pirogov 2011;(1):43–47. (In Russ.)]. EDN: NZGEVF.
7. Klimov V. S., Vasilenko I. I., Ryabykh O. S. Influence of sagittal balance reconstruction on the results of treatment of elderly and senile patients with degenerative spondylolisthesis of low degree of gradation: analysis of a multicenter four-year cohort. Genius of orthopedics. 2020;26(4):555–564. (In Russ.)]. Doi: 10.18019/1028-4427-2020-26-4-555-564. EDN: YUMKFJ.
8. Krutko A. V. Sagittal balance. Harmony in formulas. Novgorod: ANO «Klinika NIITO»; 2016. 64 p. (In Russ.)]. EDN: YVUYQF.
9. Roerich V. V., Borzykh K. O. Posttraumatic deformities of the thoracic and lumbar spine in patients in the late period of spinal cord injury after previously performed surgical interventions. International Journal of Applied and Fundamental Research. 2015;12(4):657–660. (In Russ.)]. EDN: VBUMWX.
10. Lastevsky A. D., Popelyukh A. I., Veselov S. V. et al. Biomechanical aspects of primary stability of instrumental fixation in the treatment of dislocations of the cervical vertebrae of subaxial localization: an experimental study. Spine surgery. 2021;18(3):43–52. (In Russ.)]. Doi 10.14531/ss2021.3.43-52. EDN: QLYXRP.
11. Mikhailovsky M. V., Novikov V. V., Vasyura A. S. et al. Operative correction of congenital kyphoses in patients older than 10 years. Spine surgery. 2016;13(1): 20–26. (In Russ.)]. Doi 10.14531/ss2016.1.20-26. EDN: VQGEDT.
12. Lee S. H., Kim K. T., Seo E. M. et al. The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech. 2012;25(2):41–47. Doi: 10.1097/BSD.0b013e3182396301.
13. Mizutani J., Inoue N., Otsuka Y. et al. Biomechanical and Anatomical Validity of the Short Posterior Arch Screw. Neurospine. 2019;16(2):347–353. Doi: 10.14245/ns.1836156.078.
14. Salameh M., Bizdikian A. J., Saad E. et al. Reliability assessment of cervical spine parameters measured on full-body radiographs in asymptomatic subjects and patients with spinal deformity. Orthop Traumatol Surg Res. 2021;107(7):103026. Doi: 10.1016/j.otsr.2021.103026.
15. Kassar-Pullichino V. N. Spinal injury in the light of diagnostic imaging. Moscow: MEDpressinform; 2009. 264 p. (In Russ.)]. EDN: QLTRXX.
16. Holly L. T. Management ofcervical spondylotic myelopathy with insightsfrom metabolic imaging ofthespinal cord and brain. Current Opinion in Neurology. 2009;(22):575–581. Doi: 10.1097/WCO.0b013e3283325ea7.
17. Glassman S. D., Bridwell K., Dimar J. R. et al. Frank Schwab The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30(18):2024–2029. Doi: 10.1097/01.brs.0000179086.30449.96.
18. Mummaneni P. V., Deutsch H., Mummaneni V. P. Cervicothoracic kyphosis. Neurosurgery Clinics of North America. 2006;17(3):277–287. Doi: 10.4103/jcvjs.jcvjs_66_21.
19. Shimizu K., Nakamura M., Nishikawa Y. et al. Spinal Kyphosis Causes Demyelination and Neuronal Loss in the Spinal Cord: A New Model of Kyphotic Deformity. Spine. 2005;30(21):2388–2392. Doi: 10.1097/01.brs.0000184378.67465.5c.
20. Matz P. G., Anderson P. A., Holly L. T. et al. The Natural history of cervical spondylotic myelopathy. Journal of Neurosurgery. Spine. 2009;11(2):104–111. Doi: 10.7759/cureus.5074.
21. Simmons R. L., Owen S., Abbott C. J. et al. Naproxen sodium and paracetamol/ dextropropoxyphene in sports injuries – a multicentre comparative study. British Journal of Sports Medicine. 1982;16(2):91–95. Doi: 10.1136/bjsm.16.2.91.
22. Ames C. P., Smith J. S., Scheer J. K. et al. A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction. Journal of Neurosurgery: Spine SPI. 2013;19(3):269–278. Doi: 10.3171/2013.5.SPINE121067.
23. Grosso M. J., Hwang R., Krishnaney A. A. et al. Complications and outcomes for surgical approaches to cervical kyphosis. J Spinal Disord Tech. 2015;28(7):385–393. Doi: 10.1097/BSD.0b013e318299953f.
24. Etame A. B., Wang A. C., Than K. D. Outcomes after surgery for cervical spine deformity: review of the literature. Neurosurgical Focus. 2010;28(3). Doi: 10.3171/2010.1.FOCUS09278.
25. TraynelisV.C., MaranoG.D., DunkerR.O. et al. Traumatic atlantooccipital dislocation. Case report. Neurosurg. 1986;65(6):863–870. Doi: 10.3171/jns.1986.65.6.0863.
26. Kim L. J., Klopfenstein J. D., Zabramski J. M. et al. Analysis of pain resolution after surgical resection of intramedullary spinal cord cavernous malformations. Neurosurgery. 2006;58(1):106–111. Doi: 10.3171/jns.10.1227/01.neu.0000192161.95893.d7.
27. Westerveld L., Verlaan J. J., Oner F. C. Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. European Spine Journal. 2009;(18):145–156. Doi: 10.1007/s00586-008-0764-0.
28. Smith J., Singh M., Klineberg E. et al. Surgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis. J Neurosurg Spine. 2014;21(2):160–170. Doi: 10.3171/2014.3.SPINE13580.
Review
For citations:
Biragov D.V., Gulyaev D.A., Godanyuk D.S. Surgical strategies for treatment of secondary cervical subaxial spine kyphotic deformities (review). Russian Neurosurgical Journal named after Professor A. L. Polenov. 2024;16(2):174-183. (In Russ.) https://doi.org/10.56618/2071-2693_2024_16_2_174. EDN: JPLQCZ
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