Spinal alignment, surgery, and outcomes in cervical deformity: A practical guide to aid the spine surgeon

Frederico Tundo, Mauricio J. Avila, Laura Willard, Sandra Fanous, Cloe Curri, Ibrahim Hussain, Ali A. Baaj

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Compared to the thoracolumbar spine, the literature on cervical spine alignment is scarce. While a consistent number of articles have been published, few analyze the ideal surgical approaches for each type of deformity and the optimal amount of correction to achieve. This paper provides a comprehensive review of current literature on cervical spinal deformities (with or without myelopathy) and their surgical management; it is our goal to create a framework on which surgical planning can be made. A general assessment of the actually utilized parameters and correlation between the cervical and thoracolumbar spine alignment is presented. Moreover, we provide an analysis of cervical surgical approaches (anterior, posterior, or combined), techniques (laminoplasty, laminectomy and fusion, anterior cervical discectomy and fusion, corpectomy), and their indications. Finally, a complete evaluation of outcomes and postoperative health-related quality of life (HRQOL) measures based on questionnaires (NDI, VAS, SF-36, mJOA) is discussed. Several prospective studies would be useful in understanding how cervical alignment may be important in the assessment and treatment of cervical deformities with or without myelopathy. In particular, future works should concentrate on the correlation between cervical alignment parameters, disability scores, and myelopathy outcomes. We propose, via comprehensive literature review, a guide of practical key points on surgical techniques, cervical alignment, and symptom improvement goals surgeons should aim to achieve for each patient.

Original languageEnglish (US)
Article number105496
JournalClinical Neurology and Neurosurgery
StatePublished - Oct 2019
Externally publishedYes


  • Alignment parameters
  • Cervical deformity
  • Cervical kyphosis
  • Cervical spine
  • Correction treatments
  • Myelopathy
  • Outcomes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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