Editor’s Choice: Cervical Spine Deformity—Part 1: Biomechanics, Radiographic Parameters, and Classification

The fundamental functions of the cervical spine include transmitting axial load from the cranium, maintaining horizontal gaze, allowing normal head and neck movement, and protecting important neurovascular structures such as spinal cord, nerve roots, and vertebral arteries. A healthy and normally functioning cervical spine is the basis for performing many activities of daily living and is essential for maintaining a good quality of life. Cervical spine deformities, however, can significantly limit the normal function of the neck and thereby diminish the patient’s quality of life.

The most common form of cervical spine deformity is cervical kyphosis. These patients most commonly present with neck pain, but may also have myelopathy, and sensorimotor deficits due to compression of the neural elements and impaired cord perfusion from an overstretched spinal cord. If the kyphotic deformity is severe (ie, chin-on-chest deformity, dropped head syndrome, etc.), patients can have significant difficulty with swallowing and maintaining horizontal gaze. Surgical treatment is often required for these symptomatic patients. The general goals of cervical spine deformity surgery include correction of deformity, restoration of the horizontal gaze, decompression of the neural elements as necessary, solid arthrodesis to maintain the surgical correction and spinal alignment, and avoidance of complications.

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