The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. METHODS: A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. RESULTS: Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. CONCLUSION: The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal alignment varied in different Roussouly type.

[Clinical observation of sarcandra glabra combined chemoradiotherapy for treating patients with local advanced nasopharyngeal carcinoma].

OBJECTIVE: To observe the short-term efficacy and radiotherapy induced acute reactions of sarcandra glabra (SG) combined chemoradiotherapy for treating patients with local advanced nasopharyngeal carcinoma. METHODS: Totally 100 nasopharyngeal carcinoma phase III - IVa patients were randomly assigned to the control group and the observation group, 50 patients in each group. All patients received chemoradiotherapy. Patients in the observation group took SG decoction at the daily dose of 20 g. RESULTS: Totally 98 patients completed the treatment. There was no statistical difference in the complete remission rate, the partial remission rate, 1-year and 2-year total survival rates, or disease free progression rate between the two groups. The occurrence rate of II - III degree radioactive oral mucositis and dry mouth were obviously lower in the observation group than in the control group, showing statistical difference (P <0.05). CONCLUSION: SG combined chemoradiotherapy could attenuate radiotherapy induced acute adverse reactions in treating advanced nasopharyngeal carcinoma.