Sagittal balance of the cervical spine in adults: a non-systematic literature review
https://doi.org/10.14531/ss2026.1.92-97
Abstract
The article presents a non-systematic review of 44 publications on sagittal balance of the cervical spine selected over the past 10 years. Currently, despite the abundance of parameters proposed for assessing the sagittal balance, no consensus has yet been reached regarding the mandatory use of specific criteria. Debates persist regarding both the boundaries of “normality” and the degree of clinical impact of even the most established parameters on a patient’s functional status. Data on the influence of various single- or multi-level surgical interventions on the cervical sagittal balance are inconsistent. Consequently, there is no consensus on the need and methods of correcting specific alterations in cervical sagittal profile parameters. As a result of the literature analysis, the following parameters of the cervical spine balance were identified, which are considered the main ones: cervical lordosis (CL), sagittal vertical axis (cSVA), T1 slope angle (T1S), the T1S-CL difference, and spinocranial angle (SCA). Reference ranges were defined for most of them: T1S – 18.5°–40°, cSVA – less than 40 mm, SCA – greater than 88.6°, and T1S-CL – less than 25° ± 5°. The impact of surgeries such as ACDF and laminoplasty on sagittal cervical balance is controversial: some authors report significant changes in parameters following both anterior decompression and laminoplasty, while others, on the contrary, indicate the absence of significant alterations.
About the Authors
R. S. Chernyshyov
National Medical and Surgical Center n.a. N.I. Pirogov, Moscow, Russia
Russian Federation
Russian Federation
Roman Sergeyevich Chernyshyov; 70 Nizhnaya pervomayskaya str., Moscow, 105203, Russia
V. B. Lebedev
National Medical and Surgical Center n.a. N.I. Pirogov, Moscow, Russia
Russian Federation
Russian Federation
Valeriy Borisovich Lebedev, MD, Cand. Sci. (Medicine)
B. R. Kinzyagulov
National Medical and Surgical Center n.a. N.I. Pirogov, Moscow, Russia
Russian Federation
Russian Federation
Bulat Rustemovich Kinzyagulov, MD, Cand. Sci. (Medicine)
A. A. Zuev
National Medical and Surgical Center n.a. N.I. Pirogov, Moscow, Russia
Russian Federation
Russian Federation
Andrey Alexandrovich Zuev, MD, Dr. Sci. (Medicine)
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Review
For citations:
Chernyshyov R.S., Lebedev V.B., Kinzyagulov B.R., Zuev A.A. Sagittal balance of the cervical spine in adults: a non-systematic literature review. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2026;23(1):92-97. https://doi.org/10.14531/ss2026.1.92-97
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