PMID- 34119284
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20210708
IS  - 1532-2653 (Electronic)
IS  - 0967-5868 (Linking)
VI  - 89
DP  - 2021 Jul
TI  - Improvement in some Ames-ISSG cervical deformity classification modifier grades 
      may correlate with clinical improvement.
PG  - 297-304
LID - S0967-5868(21)00214-9 [pii]
LID - 10.1016/j.jocn.2021.05.007 [doi]
AB  - This retrospective cohort study describes adult cervical deformity(ACD) patients 
      with Ames-ACD classification at baseline(BL) and 1-year post-operatively and 
      assesses the relationship of improvement in Ames modifiers with clinical 
      outcomes. Patients >/= 18yrs with BL and post-op(1-year) radiographs were included. 
      Patients were categorized with Ames classification by primary deformity 
      descriptors (C = cervical; CT = cervicothoracic junction; T = thoracic; 
      S = coronal) and alignment/myelopathy modifiers(C2-C7 Sagittal Vertical 
      Axis[cSVA], T1 Slope-Cervical Lordosis[TS-CL], Horizontal Gaze[Horiz], mJOA). 
      Univariate analysis evaluated demographics, clinical intervention, and Ames 
      deformity descriptor. Patients were evaluated for radiographic improvement by 
      Ames classification and reaching Minimal Clinically Important Differences(MCID) 
      for mJOA, Neck Disability Index(NDI), and EuroQuol-5D(EQ5D). A total of 73 
      patients were categorized: C = 41(56.2%), CT = 18(24.7%), T = 9(12.3%), 
      S = 5(6.8%). By Ames modifier 1-year improvement, 13(17.8%) improved in mJOA, 
      26(35.6%) in cSVA grade, 19(26.0%) in Horiz, and 15(20.5%) in TS-CL. The overall 
      proportion of patients without severe Ames modifier grades at 1-year was as 
      follows: 100% cSVA, 27.4% TS-CL, 67.1% Horiz, 69.9% mJOA. 1-year 
      post-operatively, severe myelopathy(mJOA = 3) prevalence differed between 
      Ames-ACD descriptors (C = 26.3%, CT = 15.4%, T = 0.0%, S = 0.0%, p = 0.033). 
      Improvement in mJOA modifier correlated with reaching 1-year NDI MCID in the 
      overall cohort (r = 0.354,p = 0.002). For C descriptors, cSVA improvement 
      correlated with reaching 1-year NDI MCID (r = 0.387,p = 0.016). Improvement in 
      more than one radiographic Ames modifier correlated with reaching 1-year mJOA 
      MCID (r = 0.344,p = 0.003) and with reaching more than one MCID for mJOA, NDI, 
      and EQ-5D (r = 0.272,p = 0.020). In conclusion, improvements in radiographic Ames 
      modifier grades correlated with improvement in 1-year postoperative clinical 
      outcomes. Although limited in scope, this analysis suggests the Ames-ACD 
      classification may describe cervical deformity patients' alignment and outcomes 
      at 1-year.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Horn, Samantha R
AU  - Horn SR
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Passias, Peter G
AU  - Passias PG
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA. Electronic address: Peter.Passias@nyumc.org.
FAU - Passfall, Lara
AU  - Passfall L
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Lafage, Renaud
AU  - Lafage R
AD  - Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA.
FAU - Smith, Justin S
AU  - Smith JS
AD  - Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
FAU - Poorman, Gregory W
AU  - Poorman GW
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Steinmetz, Leah M
AU  - Steinmetz LM
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Bortz, Cole A
AU  - Bortz CA
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Segreto, Frank A
AU  - Segreto FA
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Diebo, Bassel
AU  - Diebo B
AD  - Department of Orthopaedics, SUNY Downstate Medical Center, New York, NY, USA.
FAU - Hart, Robert
AU  - Hart R
AD  - Department of Orthopaedics, Swedish Neuroscience Institute, Seattle, WA, USA.
FAU - Burton, Douglas
AU  - Burton D
AD  - Department of Orthopaedics, University of Kansas Medical Center, Kansas City, KS, 
      USA.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA.
FAU - Sciubba, Daniel M
AU  - Sciubba DM
AD  - Department of Neurologic Surgery, Johns Hopkins University, Baltimore, MD, USA.
FAU - Klineberg, Eric O
AU  - Klineberg EO
AD  - Department of Orthopaedic Surgery, University of California, Davis, Sacramento, 
      CA, USA.
FAU - Protopsaltis, Themistocles S
AU  - Protopsaltis TS
AD  - Department of Orthopaedics, NYU Medical Center-Hospital for Joint Diseases, New 
      York, NY, USA.
FAU - Schwab, Frank J
AU  - Schwab FJ
AD  - Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA.
FAU - Bess, Shay
AU  - Bess S
AD  - Department of Orthopaedic Surgery, Denver International Spine Center, Denver, CO, 
      USA.
FAU - Lafage, Virginie
AU  - Lafage V
AD  - Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA.
FAU - Ames, Christopher
AU  - Ames C
AD  - Department of Neurological Surgery, University of California, San Francisco, San 
      Francisco, CA, USA.
CN  - International Spine Study Group (ISSG)
LA  - eng
PT  - Journal Article
DEP - 20210521
PL  - Scotland
TA  - J Clin Neurosci
JT  - Journal of clinical neuroscience : official journal of the Neurosurgical Society 
      of Australasia
JID - 9433352
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cervical Vertebrae/diagnostic imaging/*surgery
MH  - Humans
MH  - Lordosis/*classification/diagnostic imaging/surgery
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Postoperative Complications/epidemiology/*etiology
MH  - Radiography/methods/standards
MH  - *Severity of Illness Index
MH  - Spinal Cord Diseases/epidemiology/*etiology
OTO - NOTNLM
OT  - Adult Cervical Deformity
OT  - Ames Cervical Deformity Classification
OT  - Correction
OT  - Outcomes
OT  - SRS-Schwab Adult Spinal Deformity Classification
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2021/06/14 06:00
MHDA- 2021/07/09 06:00
CRDT- 2021/06/13 20:30
PHST- 2021/03/22 00:00 [received]
PHST- 2021/04/26 00:00 [revised]
PHST- 2021/05/01 00:00 [accepted]
PHST- 2021/06/13 20:30 [entrez]
PHST- 2021/06/14 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
AID - S0967-5868(21)00214-9 [pii]
AID - 10.1016/j.jocn.2021.05.007 [doi]
PST - ppublish
SO  - J Clin Neurosci. 2021 Jul;89:297-304. doi: 10.1016/j.jocn.2021.05.007. Epub 2021 
      May 21.