Abstract
BACKGROUND CONTEXT Often patients with cervical deformity (CD) require extensive fusions that extend into the thoracic spine. However, factors that influence the treatment approach and level selection are poorly understood. PURPOSE To examine if there are significant differences between patients with CD who have a lowest instrumented vertebrae (LIV) to the upper thoracic (UT) vs the midthoracic (MT) spine. STUDY DESIGN/SETTING Comparative cohort study. PATIENT SAMPLE Prospective adult cervical deformity database. OUTCOME MEASURES NDI, mJOA, SWAL-QOL. METHODS A prospective CD database was analyzed for the following inclusion criteria: LIV between C7-T5 and a UIV of C2, and 1 yr min follow-up (f/u). Patient demographics, operative details, radiographic parameters and clinical outcomes were compared between those with a LIV from C7-T2 (UT) vs T3-T5 (MT). X2 and independent samples T-Tests were performed for statistical analysis RESULTS A total of 64 patients met inclusion criteria for the study and 46 were included in the analysis (avg. age 62, 58% female, avg 1yr f/u) with 22 in UT vs 24 in the MT groups. No differences were seen in age or revision case prevalence, EBL, operative time or surgical approach (anterior, posterior, combined) types between groups. MT patients had a higher pre-op cSVA, TS-CL, Max Kyphosis and T9PA and were treated with a larger number of PSOs (p CONCLUSIONS Similar radiographic and clinical outcomes can be expected for UT vs MT LIVs when treating CD. Those undergoing MT had larger cervical deformities and were more likely to undergo a PSO for correction. Despite this, there were no significant differences in the rates of major and minor complications or DJK. The MT group had a higher rate revision (5% vs 21%, p=0.19) that did not reach statistical significance. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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