We would like to thank you for the opportunity to respond to the letter to the editor. We would also like to thank the authors of this letter for their interest in our research and hope that the additional information provided here addresses their concerns and questions. With regard to the first point of the difference between reducible and irreducible kyphosis, we agree that the underlying mechanisms for the two are different, and thus outcomes of surgery, cervical disc replacement or otherwise, may be different in these patient populations as well. This study included patients with passively reducible kyphosis and thus our findings are applicable to this subset of patients with nonlordotic alignment, as mentioned in the discussion section of our paper. In terms of patient-reported outcome measures (PROMs), we have included a comprehensive list of PROMs for cervical spine surgery,1 covering disease-specific measures, pain scores and general health measures. Additionally, these PROMs were obtained preoperatively and at multiple postoperative timepoints, with the early follow-up timepoint including PROMs from 2 weeks up to 3 months after surgery, thus ensuring that PROMs and pain scores in the early postoperative were effectively captured and analyzed.
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