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      Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy.

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          Abstract

          To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s).

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          Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels.

          Y Saruhashi, A Katsuura, K Mori … (2001)
          The aim of this study was to determine whether postoperative malalignment of the cervical spine after anterior interbody fusion surgery promotes degenerative changes in the neighboring intervertebral discs. Forty-two patients who underwent anterior interbody fusion surgery for cervical spondylosis and disc herniation (34 men, 8 women) were followed for an average of 9.8 years. The average age at surgery was 50.2 years. Twenty-three patients underwent a single-level fusion, 17 underwent two-level fusion, and 2 had three levels fused. The Japanese Orthopaedic Association cervical myelopathy score, with a normal score 17 points, was 11.7 before surgery and 14.9 at follow-up. Neurological status was significantly improved postoperatively, and the improvement was preserved thereafter in most cases (paired t-test, P<0.001). Degenerative changes were evident on radiological examination in the levels adjacent to the fused segment in 21 of the 42 (50%) patients. Eight of these 21 patients demonstrated neurological deterioration caused by an adjacent disc lesion. A total of 43% of the patients with adjacent-level degeneration had malalignment of the cervical spine, such as kyphosis or sigmoid curvature. In addition, degenerative change in adjacent intervertebral levels was observed in 77% of kyphoses of the fused segment. These were statistically significant (Fisher exact method, P<0.05, P<0.04, respectively). Our findings suggest that one of the factors promoting degenerative change in adjacent intervertebral levels after anterior cervical fusion for degenerative disorders is postoperative kyphotic change in the cervical spine and the fused segment.
          Article 0 comments Cited 76 times – based on 0 reviews     Review now
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            Cervical sagittal balance: a biomechanical perspective can help clinical practice.

            Avinash Patwardhan, Saeed Khayatzadeh, Robert Havey … (2018)
            In this article, we summarize our work on understanding the influence of cervical sagittal malalignment on the mechanics of the cervical spine.
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              Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: a minimum 5-year follow-up study.

              Kyung Bok Lee, Yoo Kyung Song, Seung-Hoon Song (2012)
              We evaluated radiologic and clinical outcomes to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior corpectomy and fusion (ACCF) for multilevel cervical spondylotic myelopathy (CSM). A total of 40 patients who underwent ACDF or ACCF for multilevel CSM were divided into two groups. Group A (n = 25) underwent ACDF and group B (n = 15) ACCF. Clinical outcomes (JOA and VAS scores), perioperative parameters (length of hospital stay, blood loss, operation time), radiological parameters (fusion rate, segmental height, cervical lordosis), and complications were compared. Both group A and group B demonstrated significant increases in JOA scores and significant decreases in VAS. Patients who underwent ACDF experienced significantly shorter hospital stays (p = 0.031), less blood loss (p = 0.001), and shorter operation times (p = 0.024). Both groups showed significant increases in postoperative cervical lordosis and achieved satisfactory fusion rates (88.0 and 93.3%, respectively). There were no significant differences in the incidence of complications among the groups. Both ACDF and ACCF provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stays, less blood loss, and shorter operative times.
              Article 0 comments Cited 35 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (iso-abbrev): BMC Musculoskelet Disord
                Title: BMC musculoskeletal disorders
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1471-2474
                ISSN (Print): 1471-2474
                Publication date (Electronic): Jan 05 2019
                Volume: 20
                Issue: 1
                Affiliations
                [1 ] Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
                [2 ] Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. xuweihong815@126.com.
                Article
                Publisher Item ID: 10.1186/s12891-018-2378-y
                DOI: 10.1186/s12891-018-2378-y
                PMC ID: 6320600
                PubMed ID: 30611236
                SO-VID: bafa1db5-46bc-4435-97e7-7b997850afaa
                History

                Keywords: ACHDF,C2–7 lordosis; C2–7 SVA,Sagittal alignment,T1 slope; cervical tilting
                Data availability:
                Keywords: ACHDF, C2–7 lordosis; C2–7 SVA, Sagittal alignment, T1 slope; cervical tilting

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