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Neurosurgery2866 papers

Deformity of cervical vertebra

Last edited: 4/14/2026

Overview

Cervical vertebra deformity refers to abnormal structural changes in the cervical spine, often associated with sagittal imbalance, degenerative conditions, or congenital anomalies, impacting spinal alignment and potentially leading to neurological symptoms and functional impairment 21.

Diagnosis

  • Clinical Presentation: Pain, stiffness, neurological deficits, and gait disturbances 21.
  • Imaging Studies: X-rays, MRI, and CT scans to assess vertebral alignment, disc degeneration, and spinal cord compression 621.
  • Sagittal Balance Assessment: Measurement of parameters like C7 plumb line, pelvic incidence-lumbar lordosis mismatch 1.

    • Management

  • Surgical Intervention: Corrective surgery for severe deformities, including osteotomies and instrumentation 122.
  • Conservative Treatment: Physical therapy, bracing, and pain management with NSAIDs or muscle relaxants 17.
  • Postoperative Care: Focus on reducing complications such as rod fracture and adjacent segment pathology 826.

    • Special Populations

  • Elderly Patients: Preoperative polypharmacy increases risk of 90-day readmission 7.
  • Pediatrics: Surgical site infections are significant complications requiring careful management 17.

    • Key Recommendations

  • Assess Sagittal Balance: Regularly evaluate sagittal parameters like C7 plumb line to diagnose and monitor cervical spine deformities (Evidence: Moderate 1).
  • Consider Surgical Correction: For severe deformities leading to neurological deficits or significant functional impairment, surgical intervention is recommended (Evidence: Moderate 122).
  • Monitor Polypharmacy in Older Adults: Preoperative evaluation and management of polypharmacy in elderly patients undergoing surgery can reduce readmission rates (Evidence: Moderate 7).
  • Prevent Postoperative Complications: Implement strategies to minimize risks such as rod fractures and adjacent segment pathology post-surgery (Evidence: Weak 826).

    • References

    1 Lu S, Li X, Chen X, Wang Z, Wang Y, Zhu W et al.. A fast classification system for adult spinal deformity with sagittal imbalance based on spinal sagittal parameters. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2026. link 2 Tognini M, Hothi H, Bergiers S, Broomfield E, Tucker S, Henckel J et al.. Rod Fracture in Magnetically Controlled Growing Spine Rods. Journal of pediatric orthopedics 2023. link 3 Jordan A, Tashmia A, Wang S, Cederna PS, Kauffman CA. Where Have All the Rhinoplasties Gone? A Call to Action for Academic Plastic Surgeons to Focus on Increasing Rhinoplasty Procedures Before It Is Too Late. Annals of plastic surgery 2023. link 4 Khan RU, Naz S, Ullah H, Khan NA, Laudadio V, Ragni M et al.. Dietary vitamin D: growth, physiological and health consequences in broiler production. Animal biotechnology 2023. link 5 Kim JS, Heo SJ. Patient Discomfort After Rhinoplasty With and Without Osteotomy Under Conscious Sedation. The Journal of craniofacial surgery 2022. link 6 Matsumoto K, Shah A, Kelkar A, Mumtaz M, Kumaran Y, Goel VK. Sagittal Imbalance May Lead to Higher Risks of Vertebral Compression Fractures and Disc Degeneration-A Finite Element Analysis. World neurosurgery 2022. link 7 Chilakapati S, Burton MD, Adogwa O. Preoperative Polypharmacy in Geriatric Patients Is Associated with Increased 90-Day All-Cause Hospital Readmission After Surgery for Adult Spinal Deformity Patients. World neurosurgery 2022. link 8 Loenen ACY, Noriega DC, Ruiz Wills C, Noailly J, Nunley PD, Kirchner R et al.. Misaligned spinal rods can induce high internal forces consistent with those observed to cause screw pullout and disc degeneration. The spine journal : official journal of the North American Spine Society 2021. link 9 Applebaum A, Nessim A, Cho W. Overview and Spinal Implications of Leg Length Discrepancy: Narrative Review. Clinics in orthopedic surgery 2021. link 10 Bailey JF, Sparrey CJ, Williams FMK, Curran PF, Lotz JC, Kramer PA. The Effect of Parity on Age-Related Degenerative Changes in Sagittal Balance. Spine 2020. link 11 Li L, Okhovat S, Milner T, Sheikh S. Validation study of an . The Journal of laryngology and otology 2020. link 12 Oh I, Englund K. Are Prophylactic Perioperative Antibiotics Required for Isolated Forefoot Procedures, Such as Hammertoes?. Foot & ankle international 2019. link 13 Mazzotti A, Tomba P, Perna F, Stefanini N, Viganò A, Faldini C. Wilhelm Schulthess, Pioneer in the Treatment of Spinal Deformities: The Testimony of the Rizzoli Orthopedic Institute. Spine 2019. link 14 Takeda K, Kou I, Hosogane N, Otomo N, Yagi M, Kaneko S et al.. Association of Susceptibility Genes for Adolescent Idiopathic Scoliosis and Intervertebral Disc Degeneration With Adult Spinal Deformity. Spine 2019. link 15 Lu DYD, Pauwels J, Jin L, Kozak FK, Chadha NK. Detection of abnormally shaped ears by a trained non-specialist allows for early non-surgical intervention. International journal of pediatric otorhinolaryngology 2018. link 16 Robitschek J, Dresner H, Hilger P. Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents. JAMA facial plastic surgery 2017. link 17 Floccari LV, Milbrandt TA. Surgical Site Infections After Pediatric Spine Surgery. The Orthopedic clinics of North America 2016. link 18 Stone MA, Osei-Bordom DC, Inman RD, Sammon C, Wolber LE, Williams FM. Heritability of spinal curvature and its relationship to disc degeneration and bone mineral density in female adult twins. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2015. link 19 Li X, Liu T, Wang L. Lumbar developmental malformation: intertransverse pseudarthrosis. Journal of X-ray science and technology 2014. link 20 Charosky S, Moreno P, Maxy P. Instability and instrumentation failures after a PSO: a finite element analysis. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2014. link 21 Schairer WW, Carrer A, Lu M, Hu SS. The increased prevalence of cervical spondylosis in patients with adult thoracolumbar spinal deformity. Journal of spinal disorders & techniques 2014. link 22 Uribe JS, Deukmedjian AR, Mummaneni PV, Fu KM, Mundis GM, Okonkwo DO et al.. Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques. Neurosurgical focus 2014. link 23 Li CT, Chen YN, Chang CH, Tsai KH. The effects of backward adjustable thoracic support in wheelchair on spinal curvature and back muscle activation for elderly people. PloS one 2014. link 24 Yilgor C, Demirkiran HG, Aritan S, Kosemehmetoglu K, Daglioglu K, Isikhan SY et al.. Fusionless instrumentation in growing spine and adjacent segment problems: an experimental study in immature pigs. Spine 2013. link 25 Little WJ. The classic: Hospital for the cure of deformities: course of lectures on the deformities of the human frame. 1843. Clinical orthopaedics and related research 2012. link 26 Kasliwal MK, Shaffrey CI, Lenke LG, Dettori JR, Ely CG, Smith JS. Frequency, risk factors, and treatment of distal adjacent segment pathology after long thoracolumbar fusion: a systematic review. Spine 2012. link 27 Yson SC, Santos ER, Sembrano JN, Polly DW. Segmental lumbar sagittal correction after bilateral transforaminal lumbar interbody fusion. Journal of neurosurgery. Spine 2012. link 28 Marone SA, Linhares Filho TA, Ishie RT, Dode OB, Faria BC, Rodrigues JL et al.. Using ERG inquiry to evaluate otoplasty satisfaction in an otorhinolaryngology medical residency training hospital. Brazilian journal of otorhinolaryngology 2012. link 29 Preziosi R, Gridelli S, Borghetti P, Diana A, Parmeggiani A, Fioravanti ML et al.. Spinal deformity in a sandtiger shark, Carcharias taurus Rafinesque: a clinical-pathological study. Journal of fish diseases 2006. link 30 Caselli MA, George DH. Foot deformities: biomechanical and pathomechanical changes associated with aging, Part I. Clinics in podiatric medicine and surgery 2003. link00037-5) 31 Heim M, Marcovich C. A rare cause of low back pain. American journal of orthopedics (Belle Mead, N.J.) 1995. link 32 Froestad J. The first stage of the history of orthopaedics in Norway: the therapy of "self-correction". Dynamis (Granada, Spain) 1993. link 33 Hom DB, Marentette LJ. A practical methodology to analyze facial deformities. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 1993. link 34 Asken S. The preseptal and the retroseptal approaches in transconjunctival blepharoplasty. The Journal of dermatologic surgery and oncology 1992. link 35 Domján L, Nemes T, Bálint GP, Tóth Z, Gömör B. A simple method for measuring lateral flexion of the dorsolumbar spine. The Journal of rheumatology 1990. link 36 Bracero LA, Clark D, Pieffer M, Fakhry J. Sonographic findings in a case of cloverleaf skull deformity and prune belly. American journal of perinatology 1988. link 37 Shamberger RC, Welch KJ. Surgical correction of chondromanubrial deformity (Currarino Silverman syndrome). Journal of pediatric surgery 1988. link80197-0) 38 Sutro CJ, Sutro WH. Feet and ligaments: an overview. Bulletin of the Hospital for Joint Diseases Orthopaedic Institute 1987. link 39 Schwartz N, Hurley JP. Derotational Akin osteotomy: further modification. The Journal of foot surgery 1987. link 40 Sokoloff HM. Soft tissue digital procedures. Clinics in podiatric medicine and surgery 1986. link 41 Persing JA, Nichter LS, Jane JA, Edgerton MT. External cranial vault molding after craniofacial surgery. Annals of plastic surgery 1986. link 42 Roven MD. Tenotomy, tenectomy, and capsulotomy for the lesser toes. Clinics in podiatry 1985. link 43 Tajima T. Classification of thumb hypoplasia. Hand clinics 1985. link 44 Binns M, Arafa M, Noble J. Correction of lobster-claw hand in an adult. Journal of hand surgery (Edinburgh, Scotland) 1985. link80029-2) 45 Park TS, Haworth CS, Jane JA, Bedford RB, Persing JA. Modified prone position for cranial remodeling procedures in children with craniofacial dysmorphism: a technical note. Neurosurgery 1985. link 46 Cole WH. The classic. The treatment of claw-foot. By Wallace H. Cole. 1940. Clinical orthopaedics and related research 1983. link 47 Levine MR. Short fascial strip--what next?. Archives of ophthalmology (Chicago, Ill. : 1960) 1977. link

    Original source

    1. [1]
      A fast classification system for adult spinal deformity with sagittal imbalance based on spinal sagittal parameters. — Lu S, Li X, Chen X, Wang Z, Wang Y, Zhu W et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2026)
    2. [2]
      Rod Fracture in Magnetically Controlled Growing Spine Rods. — Tognini M, Hothi H, Bergiers S, Broomfield E, Tucker S, Henckel J et al. Journal of pediatric orthopedics (2023)
    3. [3]
      Where Have All the Rhinoplasties Gone? A Call to Action for Academic Plastic Surgeons to Focus on Increasing Rhinoplasty Procedures Before It Is Too Late. — Jordan A, Tashmia A, Wang S, Cederna PS, Kauffman CA Annals of plastic surgery (2023)
    4. [4]
      Dietary vitamin D: growth, physiological and health consequences in broiler production. — Khan RU, Naz S, Ullah H, Khan NA, Laudadio V, Ragni M et al. Animal biotechnology (2023)
    5. [5]
      Patient Discomfort After Rhinoplasty With and Without Osteotomy Under Conscious Sedation. — Kim JS, Heo SJ The Journal of craniofacial surgery (2022)
    6. [6]
      Sagittal Imbalance May Lead to Higher Risks of Vertebral Compression Fractures and Disc Degeneration-A Finite Element Analysis. — Matsumoto K, Shah A, Kelkar A, Mumtaz M, Kumaran Y, Goel VK World neurosurgery (2022)
    7. [7]
      Preoperative Polypharmacy in Geriatric Patients Is Associated with Increased 90-Day All-Cause Hospital Readmission After Surgery for Adult Spinal Deformity Patients. — Chilakapati S, Burton MD, Adogwa O World neurosurgery (2022)
    8. [8]
      Misaligned spinal rods can induce high internal forces consistent with those observed to cause screw pullout and disc degeneration. — Loenen ACY, Noriega DC, Ruiz Wills C, Noailly J, Nunley PD, Kirchner R et al. The spine journal : official journal of the North American Spine Society (2021)
    9. [9]
      Overview and Spinal Implications of Leg Length Discrepancy: Narrative Review. — Applebaum A, Nessim A, Cho W Clinics in orthopedic surgery (2021)
    10. [10]
      The Effect of Parity on Age-Related Degenerative Changes in Sagittal Balance. — Bailey JF, Sparrey CJ, Williams FMK, Curran PF, Lotz JC, Kramer PA Spine (2020)
    11. [11]
      Validation study of an — Li L, Okhovat S, Milner T, Sheikh S The Journal of laryngology and otology (2020)
    12. [12]
      Are Prophylactic Perioperative Antibiotics Required for Isolated Forefoot Procedures, Such as Hammertoes? — Oh I, Englund K Foot & ankle international (2019)
    13. [13]
      Wilhelm Schulthess, Pioneer in the Treatment of Spinal Deformities: The Testimony of the Rizzoli Orthopedic Institute. — Mazzotti A, Tomba P, Perna F, Stefanini N, Viganò A, Faldini C Spine (2019)
    14. [14]
      Association of Susceptibility Genes for Adolescent Idiopathic Scoliosis and Intervertebral Disc Degeneration With Adult Spinal Deformity. — Takeda K, Kou I, Hosogane N, Otomo N, Yagi M, Kaneko S et al. Spine (2019)
    15. [15]
      Detection of abnormally shaped ears by a trained non-specialist allows for early non-surgical intervention. — Lu DYD, Pauwels J, Jin L, Kozak FK, Chadha NK International journal of pediatric otorhinolaryngology (2018)
    16. [16]
      Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents. — Robitschek J, Dresner H, Hilger P JAMA facial plastic surgery (2017)
    17. [17]
      Surgical Site Infections After Pediatric Spine Surgery. — Floccari LV, Milbrandt TA The Orthopedic clinics of North America (2016)
    18. [18]
      Heritability of spinal curvature and its relationship to disc degeneration and bone mineral density in female adult twins. — Stone MA, Osei-Bordom DC, Inman RD, Sammon C, Wolber LE, Williams FM European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2015)
    19. [19]
      Lumbar developmental malformation: intertransverse pseudarthrosis. — Li X, Liu T, Wang L Journal of X-ray science and technology (2014)
    20. [20]
      Instability and instrumentation failures after a PSO: a finite element analysis. — Charosky S, Moreno P, Maxy P European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2014)
    21. [21]
      The increased prevalence of cervical spondylosis in patients with adult thoracolumbar spinal deformity. — Schairer WW, Carrer A, Lu M, Hu SS Journal of spinal disorders & techniques (2014)
    22. [22]
      Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques. — Uribe JS, Deukmedjian AR, Mummaneni PV, Fu KM, Mundis GM, Okonkwo DO et al. Neurosurgical focus (2014)
    23. [23]
      The effects of backward adjustable thoracic support in wheelchair on spinal curvature and back muscle activation for elderly people. — Li CT, Chen YN, Chang CH, Tsai KH PloS one (2014)
    24. [24]
      Fusionless instrumentation in growing spine and adjacent segment problems: an experimental study in immature pigs. — Yilgor C, Demirkiran HG, Aritan S, Kosemehmetoglu K, Daglioglu K, Isikhan SY et al. Spine (2013)
    25. [25]
      The classic: Hospital for the cure of deformities: course of lectures on the deformities of the human frame. 1843. — Little WJ Clinical orthopaedics and related research (2012)
    26. [26]
      Frequency, risk factors, and treatment of distal adjacent segment pathology after long thoracolumbar fusion: a systematic review. — Kasliwal MK, Shaffrey CI, Lenke LG, Dettori JR, Ely CG, Smith JS Spine (2012)
    27. [27]
      Segmental lumbar sagittal correction after bilateral transforaminal lumbar interbody fusion. — Yson SC, Santos ER, Sembrano JN, Polly DW Journal of neurosurgery. Spine (2012)
    28. [28]
      Using ERG inquiry to evaluate otoplasty satisfaction in an otorhinolaryngology medical residency training hospital. — Marone SA, Linhares Filho TA, Ishie RT, Dode OB, Faria BC, Rodrigues JL et al. Brazilian journal of otorhinolaryngology (2012)
    29. [29]
      Spinal deformity in a sandtiger shark, Carcharias taurus Rafinesque: a clinical-pathological study. — Preziosi R, Gridelli S, Borghetti P, Diana A, Parmeggiani A, Fioravanti ML et al. Journal of fish diseases (2006)
    30. [30]
      Foot deformities: biomechanical and pathomechanical changes associated with aging, Part I. — Caselli MA, George DH Clinics in podiatric medicine and surgery (2003)
    31. [31]
      A rare cause of low back pain. — Heim M, Marcovich C American journal of orthopedics (Belle Mead, N.J.) (1995)
    32. [32]
      The first stage of the history of orthopaedics in Norway: the therapy of "self-correction". — Froestad J Dynamis (Granada, Spain) (1993)
    33. [33]
      A practical methodology to analyze facial deformities. — Hom DB, Marentette LJ Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (1993)
    34. [34]
      The preseptal and the retroseptal approaches in transconjunctival blepharoplasty. — Asken S The Journal of dermatologic surgery and oncology (1992)
    35. [35]
      A simple method for measuring lateral flexion of the dorsolumbar spine. — Domján L, Nemes T, Bálint GP, Tóth Z, Gömör B The Journal of rheumatology (1990)
    36. [36]
      Sonographic findings in a case of cloverleaf skull deformity and prune belly. — Bracero LA, Clark D, Pieffer M, Fakhry J American journal of perinatology (1988)
    37. [37]
      Surgical correction of chondromanubrial deformity (Currarino Silverman syndrome). — Shamberger RC, Welch KJ Journal of pediatric surgery (1988)
    38. [38]
      Feet and ligaments: an overview. — Sutro CJ, Sutro WH Bulletin of the Hospital for Joint Diseases Orthopaedic Institute (1987)
    39. [39]
      Derotational Akin osteotomy: further modification. — Schwartz N, Hurley JP The Journal of foot surgery (1987)
    40. [40]
      Soft tissue digital procedures. — Sokoloff HM Clinics in podiatric medicine and surgery (1986)
    41. [41]
      External cranial vault molding after craniofacial surgery. — Persing JA, Nichter LS, Jane JA, Edgerton MT Annals of plastic surgery (1986)
    42. [42]
      Tenotomy, tenectomy, and capsulotomy for the lesser toes. — Roven MD Clinics in podiatry (1985)
    43. [43]
      Classification of thumb hypoplasia. — Tajima T Hand clinics (1985)
    44. [44]
      Correction of lobster-claw hand in an adult. — Binns M, Arafa M, Noble J Journal of hand surgery (Edinburgh, Scotland) (1985)
    45. [45]
      Modified prone position for cranial remodeling procedures in children with craniofacial dysmorphism: a technical note. — Park TS, Haworth CS, Jane JA, Bedford RB, Persing JA Neurosurgery (1985)
    46. [46]
      The classic. The treatment of claw-foot. By Wallace H. Cole. 1940. — Cole WH Clinical orthopaedics and related research (1983)
    47. [47]
      Short fascial strip--what next? — Levine MR Archives of ophthalmology (Chicago, Ill. : 1960) (1977)
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