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Blake N. Staub, Renaud Lafage, Han Jo Kim, Christopher I. Shaffrey, Gregory M. Mundis Jr., Richard Hostin, Douglas Burton, Lawrence Lenke, Munish C. Gupta, Christopher Ames, Eric Klineberg, Shay Bess, Frank Schwab, Virginie Lafage, and the International Spine Study Group

there previously was none. The T1 slope (T1S) is possibly the key to understanding cervical sagittal alignment. 21 Given its correlation with the thoracic inlet angle (TIA), thoracic kyphosis (TK), cSVA, CL, and T1S minus CL (T1S−CL), T1S appears to be the lone variable linking both the cervical and thoracolumbar spinopelvic parameters. 9 , 14 , 20 , 21 , 30 In addition, of all of the cervical parameters, T1S has the strongest correlation with the C2 plumbline. 16 Despite the postulation by Iyer et al. that CL, T1S, and T1S−CL all correlate with HRQOL measures in

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Darryl Lau, Anthony M. DiGiorgio, Andrew K. Chan, Cecilia L. Dalle Ore, Michael S. Virk, Dean Chou, Erica F. Bisson, and Praveen V. Mummaneni

produce improvements in cSVA and cervical lordosis (CL), 8 , 14 , 17 , 35 but the interplay between HRQOL and radiographic measures remains incompletely characterized. In this series, we sought to prospectively investigate the relationship between cervical parameters, specifically cSVA, CL, and T1 slope, and postoperative pain (neck and arm pain, as measured using the VAS) and disability (NDI and EQ-5D) outcomes at 3 and 12 months in a population of patients without spinal deformity who were undergoing ACDF. We also sought to identify additional factors predictive of

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Takeshi Oichi, Yasushi Oshima, Hiroyuki Oka, Yuki Taniguchi, Hirotaka Chikuda, Yoshitaka Matsubayashi, Katsushi Takeshita, and Sakae Tanaka

] − preoperative JOA score) × 100 (%). 4 Radiological Evaluation CT Measurements Cervical CT scans were obtained for all patients before surgery with the subject in a comfortable supine position and gazing at the ceiling. The T-1 slope was usually measured using full-standing radiographs; 13 however, in our cohort, there were many cases (n = 42) in which accurate measurement of the T-1 slope on cervical radiographs was difficult due to the interference of the shoulder, as reported previously. 9 Alternatively, we measured the T-1 slope using 3D CT scans, which has been reported

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Seung-Jae Hyun, Ki-Jeong Kim, and Tae-Ahn Jahng

. Patients who presented with trauma, tumor, or ankylosing spondylitis of the spine; had a thoracolumbar deformity or prior fusion surgery in the lumbosacral spine; had a history of hip, knee, or ankle arthroplasty or arthrodesis; or had difficulty in taking a standing entire spine or whole-body radiograph or having their T1 slope (T1S) determined were excluded. Radiographic Definitions and Measurements Pre- and postoperative lateral standing whole-body EOS images were obtained with the patients standing in a neutral position and instructed to look straight ahead

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Liang Xu, Benlong Shi, Yong Qiu, Zhonghui Chen, Xi Chen, Song Li, Changzhi Du, Qingshuang Zhou, Zezhang Zhu, and Xu Sun

. During rod placement, multiple rounds of compression in the area with Ponte osteotomies were employed to enhance kyphosis correction. Final tightening was performed, and posterior fusion was completed with local and allograft bone. Radiographic Evaluation Radiographs were acquired with each patient in a standardized standing position. The parameters evaluated in the sagittal plane were as follows: 1) CL: the Cobb angle between the inferior endplate of C2 and the lower endplate of C7; 2) T1 slope: the angle between the horizontal line and the superior endplate of T1; 3

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The effect of C2–3 disc angle on postoperative adverse events in cervical spondylotic myelopathy

Presented at the 2018 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Bryan S. Lee, Kevin M. Walsh, Daniel Lubelski, Konrad D. Knusel, Michael P. Steinmetz, Thomas E. Mroz, Richard P. Schlenk, Iain H. Kalfas, and Edward C. Benzel

adjacent segment disease, which can lead to neurological compromise and the need for reoperation. 11 , 15 , 19 , 22 , 26 , 35 Several demographic and pathological factors play a role in the development and progression of adjacent segment disease and kyphosis. A thorough preoperative evaluation of the images is essential, as certain radiographic values have been demonstrated to be predictive of postoperative complications and overall outcomes. 1 , 5 , 25 , 37 , 41 , 44 Previous studies have correlated cervical sagittal imbalance, elevated T1 slope, and kyphosis with

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Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Hyun Chul Shin, Do Heum Yoon, and Yoon Ha

Clinical Assessments Standing plain radiographs (anteroposterior, lateral, flexion, and extension), CT, and MRI of the cervical spine were obtained pre- and postoperatively ( Table 1 ). Cervical spine alignment parameters included the C2–7 Cobb angle (Cobb angle from C-2 to C-7), C2–7 sagittal vertical axis (SVA), and T-1 slope minus C2–7 Cobb angle. TABLE 1. Patient demographic data, radiological parameters, and clinical outcomes Variable Kyphosis Straight Lordosis Total p Value * No. of patients 7 18 25 50

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Mark Attiah, Bilwaj Gaonkar, Yasmine Alkhalid, Diane Villaroman, Rogelio Medina, Christine Ahn, Tianyi Niu, Joel Beckett, Christopher Ames, and Luke Macyszyn

the line drawn from the vertebral body center of T1 and the center of the bicoxofemoral axis. Figure 1 shows an example of these measurements. From these measurements, the following relationships were calculated: T1 slope/CL, TK/LL, PI−LL, “ideal” LL (PI + 10°), and absolute LL−PT. FIG. 1. Measurements of sagittal parameters on a representative sagittal radiograph. TPA = T1 pelvic angle; T1S = T1 slope. Figure is available in color online only. The data were analyzed with the use of Python software (Python Software Foundation). We first subdivided the cohort by

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Justin S. Smith, Christopher I. Shaffrey, Virginie Lafage, Benjamin Blondel, Frank Schwab, Richard Hostin, Robert Hart, Brian O'Shaughnessy, Shay Bess, Serena S. Hu, Vedat Deviren, Christopher P. Ames, and International Spine Study Group

pelvic parameters. Measurements for the study included the following: C2–3 angle, C2–7 cervical lordosis measured using the Cobb method, T2–12 TK, T1–S1 LL, PT, PI, SS, C7–S1 plumb line, C-2 plumb line relative to S-1 (C2–S1 plumb line), C-2 plumb line relative to C-7 (C2–7 plumb line), T-1 spinopelvic inclination, PI − LL (reflects the mismatch between PI and LL), and T-1 slope 16 (angle between the superior endplate of T-1 and the horizontal). Regional spinal inclinations were calculated by determining the angle between a line connecting the centers of the

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Jae Hwan Cho, Chang Ju Hwang, Young Hyun Choi, Dong-Ho Lee, and Choon Sung Lee

standing radiographs. The sagittal parameters included occiput (Oc)–C2 and C2–7 lordosis, C2–7 SVA, T-1 slope, thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), and C7–S1 SVA. Oc–C2 lordosis was measured as the angle between the line from the anterosuperior border of the atlas to the inferior end of the occiput and lower endplates of C-2. C2–7 lordosis was defined as the Cobb angle between the lower endplates of C-2 and C-7. C2–7 SVA was defined as the distance from the posterosuperior corner of C-7 and the vertical line from the center of the C-2 body. T