J Neurosurg Spine 42:309–319, 2025
This study assessed surgeons’ ability to achieve preoperative sagittal alignment goals in adult cervical spine deformity surgeries. Results showed significant deviations from targets, especially in severe deformities, highlighting the need for improved surgical planning and personalized implants.
Study Overview
• Objective: Assess surgeons’ ability to achieve preoperative sagittal alignment goals in CSD surgery.
• Methods: Prospective study with adult CSD patients across 13 North American centers.
• Patient Demographics: Mean age 63.6 years; 51.1% women; 38.6% had previous cervical fusion.
Key Findings
• Alignment Goals: Surgeons failed to meet goals by 17.2 mm for C2–7 SVA, 10.3° for Cobb angle.
• Factors Affecting Outcomes: Greater baseline TK linked to better Cobb angle achievement.
• Surgical Planning: 60% used PACS, 33.3% used spine-specific software.
• Tools and Criteria: Ames/ISSG criteria used by 33.3% of surgeons; others individualized goals.
Challenges and Recommendations
• Severe Deformities: More challenging to achieve alignment goals in severe cases.
• Need for Advancements: Personalized implants could improve intraoperative goal achievement.
• Alignment Correlations: Strong correlation for C7–S1 SVA, weak for C2–7 SVA.
Statistical Analysis
• Offset Groups: Patients categorized by offset magnitude from goal alignment.
• Significant Associations: Lower baseline TS-CL associated with better TS-CL goal achievement.
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