Proposal of a Cervical Sagittal Classification System to Guide Surgical Treatment for Adult Cervical Deformity

We define normative cervical alignment utilizing the MEANS cohort and propose a classification system to identify the spinal region driving the cervical deformity. Types 1A-B represent well-compensated alignment. Type 2 and 3 were considered to have deformities in the cervical spine and thoracolumbar spine, respectively. Type 4 spines have a combined deformity. This can help guide the surgeon to determine the appropriate region that should be addressed with surgery.