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J. Patrick Johnson, Carl Lauryssen, Helen O. Cambron, Robert Pashman, John J. Regan, Neel Anand and Robert Bray


The authors evaluated cervical spine radiographs to determine sagittal alignment in patients who underwent one- or two-level arthroplasty with the Bryan cervical artificial disc prosthesis.


The curvature of the surgically treated spinal segments and the overall curvature of the cervical spine were evaluated in 13 patients who underwent 16 cervical arthroplasty device placements. Preoperative and postoperative lateral radiographs were reviewed and compared using standardized techniques for measuring spinal curvature. Patients who underwent a single-level cervical arthroplasty had a 4.7° mean reduction (p < 0.05) in lordosis after cervical artificial disc replacement. The three patients who underwent two-level cervical arthroplasty had no significant changes in the sagittal alignment.


Patients who underwent arthroplasty with a Bryan cervical artificial disc had a focal loss of lordosis (that is, kyphosis) at the treated levels after single-level procedures. Nevertheless, there was no significant change in the overall sagittal curvature of the cervical spine after single-level artificial disc replacements. The patients who underwent two-level artificial disc placement had no significant changes in lordosis at the treated levels or in the overall curvature. The likely source of this outcome appears to be the endplate milling procedures that reorient the vertebral endplates.

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Neel Anand, Eli M. Baron and Babak Khandehroo

was less than 50 mm compared with postoperative SVA greater than 50 mm ( Table 3 ). The implication here is that other techniques may be necessary to achieve optimal sagittal alignment in cases of greater than 100 mm positive sagittal balance ( Fig. 5 ). Other techniques such as minimally invasive anterior longitudinal ligament release, 9 anterior lumbar interbody fusion (ALIF) at L5–S1, or posterior column osteotomies may afford increased lordosis, and thus, better result in correction of the SVA. In terms of achieving a postoperative pelvic incidence minus lumbar

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Raqeeb M. Haque, Gregory M. Mundis Jr., Yousef Ahmed, Tarek Y. El Ahmadieh, Michael Y. Wang, Praveen V. Mummaneni, Juan S. Uribe, David O. Okonkwo, Robert K. Eastlack, Neel Anand, Adam S. Kanter, Frank La Marca, Behrooz A. Akbarnia, Paul Park, Virginie Lafage, Jamie S. Terran, Christopher I. Shaffrey, Eric Klineberg, Vedat Deviren and Richard G. Fessler

Corrective Measures S2-166 – S2-181 , 2002 15 Lafage V , Ames C , Schwab F , Klineberg E , Akbarnia B , Smith J , : Changes in thoracic kyphosis negatively impact sagittal alignment after lumbar pedicle subtraction osteotomy: a comprehensive radiographic analysis . Spine (Phila Pa 1976) 37 : E180 – E187 , 2012 16 Li G , Passias P , Kozanek M , Fu E , Wang S , Xia Q , : Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up . Spine (Phila Pa

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examined include presence of interbody fusion, rod diameter, rod material, age and preop sagittal alignment. Methods: A retrospective review of a multicenter, prospective ASD database was conducted. Inclusion criteria: age=18yr, ASD, no revisions between >6wk and <2yrs postop. Spinal pelvic parameters, thoracic kyphosis (TK:T2-T12) and lumbar lordosis (LL:L1-S1) were measured overall and within and outside of the instrumented segments. Changes for SVA, PT, PI-LL, TK, and LL between 6wks-2yrs postop were calculated. Of these pts, the amount of thoracic loss and TL

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-0684 American Association of Neurological Surgeons 10.3171/2017.3.FOC-DSPNabstracts 2017.3.FOC-DSPNABSTRACTS Charles Kuntz Scholar Award Presentations (Abstracts 104–123) 119. Laminoplasty vs. Laminectomy-Fusion for the Treatment of Cervical Myelopathy: Preliminary Results from the CSM-Study Comparing Cervical Sagittal Alignment and Clinical Outcomes Vijay Ravindra , MD, MSPH , Jill Curran , MS , Praveen V. Mummaneni , MD , Adam S. Kanter , MD , Erica Fay Bisson , MD, MPH , Robert F. Heary , MD

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sagittal alignment on MRI. In addition, no study has shown clinical superiority of flexion-extension xrays compared to upright static xrays in order to diagnose a lumbar anterolisthesis. Methods We retrospectively evaluated all patients presenting to spine clinic for degenerative lumbar conditions for 24 consecutive months who had an MRI, upright lateral, as well as flexion-extension radiographs at our institution. Comparing radiographic reads by a musculoskeletal radiologist, the incidence of degenerative spondylolisthesis found on dynamic flexion

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30; p<0.001). Conclusions The addition of PPI seems to have a protective effect on the development of PJK. The analysis controlled for preoperative sagittal alignment as well as for correction of PI-LL. HYB was effective in restoring sagittal global alignment and cMIS in maintaining it. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2014.3.FOC-DSPNABSTRACTS Abstract Mayfield Clinical Science 243. Microendoscopic Decompression for Cervical Spondylotic Myelopathy

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greater Charlson comorbidity index (1.1 vs 0.85) than NONOP (n=446), respectively (p<0.05). OP had worse HRQOL scores on all surveys than NONOP (p<0.05). OP and NONOP had similar coronal alignment (p<0.05). OP had worse sagittal spinopelvic alignment for all measures than NONOP except cervical lordosis, TK and pelvic incidence (PI). OP had greater percentage of pure sagittal classification (type S; OP=23%, NON=14%; p<0.05). OP had worse grades for all modifier categories: PT (26% vs 16%), PI-lumbar lordosis mismatch (37% vs 21%) and global sagittal alignment (29% vs 9