Anterior cervical discectomy and fusion can restore cervical sagittal alignment in degenerative cervical disease.
Eur J Orthop Surg Traumatol
; 29(4): 767-774, 2019 May.
Article
em En
| MEDLINE
| ID: mdl-30684057
ABSTRACT
OBJECTIVE:
The purpose of this study was to evaluate its effect on the restoration and maintenance of cervical sagittal alignment in usual cervical degenerative diseases without preoperative sagittal malalignment. MATERIALS ANDMETHODS:
We retrospectively evaluated 108 patients who were diagnosed with degenerative cervical disease and underwent ACDF (allograft and plating) with > 1-year follow-up. For radiographic evaluation, we analysed segmental and C2-7 cervical lordosis, disc height, C2-7 sagittal vertical axis (SVA), T1 slope, and T1 slope minus C2-7 lordosis (T1S - CL) in lateral X-ray. Clinical assessment was based on arm VAS, neck VAS, and NDI scores. Correlation analysis was performed across the pre-post-changes in radiological parameters. Correlations between the changes in radiological and clinical parameters at final follow-up were also analysed.RESULTS:
C2-7 lordosis was 7.13° preoperatively and increased to 13.06° (p < 0.001) and maintained at 10.08° at final follow-up (p = 0.007). Segmental lordosis increased from 0.66° to 8.33° and maintained at 5.19° (p < 0.001). Segmental disc height was 4.67 mm preoperatively (increased to 7.13 mm postoperatively and decreased to 5.74 mm at final follow-up) (p < 0.001). SVA distance (31.53 mm to 30.02 mm) (p = 0.750) and T1 slope (30.03° to 31.37°) did not show meaningful change after surgery. Increase in segmental lordosis was correlated to an increase in C2-7 lordosis (p < 0.001). C2-7 SVA change correlated with both the T1 slope change (p < 0.001) and T1S - CL (p = 0.012). Change in SVA was correlated to a change in segmental lordosis and T1 slope (p = 0.003, p = 0.014). Clinical outcomes did not correlate with radiological findings.CONCLUSION:
ACDF for the treatment of degenerative cervical disease without preoperative deformity was effective in restoring cervical sagittal alignment. Improvement of segmental lordosis related to an improvement in C2-7 lordosis and SVA. Radiological sagittal alignment did not show any relation with clinical outcomes in usual degenerative cases.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Fusão Vertebral
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Vértebras Cervicais
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Discotomia
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Espondilose
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Lordose
Tipo de estudo:
Observational_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Orthop Surg Traumatol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos