Se-Il Jeon1, Seung-Jae Hyun2, Sanghyun Han1, Byoung Hun Lee1, Ki-Jeong Kim1, Tae-Ahn Jahng1, Hyun-Jib Kim1. 1. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. 2. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. Electronic address: hyunsj@snu.ac.kr.
Abstract
BACKGROUND: T1 slope minus C2-7 lordosis (TS-CL) and cervical sagittal alignment reportedly affect health-related quality of life (HRQOL) scores after multilevel posterior cervical fusion surgery. There are no reports of a relationship between cervical alignment and patient outcomes after anterior cervical discectomy and fusion (ACDF) involving 3 or more levels. This study aimed to investigate the relationship between cervical sagittal alignment and patient-reported HRQOL after ACDF involving 3 or more levels. METHODS: Thirty-three patients underwent ACDF involving 3 or more levels for cervical stenosis, cervical degenerative disorder, or ossification of the posterior longitudinal ligament (February 2006-April 2015). Mean follow-up duration was 57.6 ± 33.2 months. Radiographic measurements included C0-2 lordosis, C2-7 lordosis, C2-7 sagittal vertical axis (SVA), T1 slope, and T1 slope minus cervical lordosis (TS-CL). Clinical outcomes were evaluated by Neck Disability Index (NDI) and visual analog scale (VAS) scores. RESULTS: There were significant correlations between C2-7 lordosis and T1 slope (r = 0.581, P = 0.004), and between C2-7 lordosis and TS-CL (r = -0.579, P = 0.004). C2-7 lordosis, C2-7 SVA, and TS-CL had no significant correlations with NDI or VAS score after surgery. C2-7 SVA was not significantly different before and after surgery. Postoperative TS-CL (P = 0.01) and changes in T1 slope (P = 0.028) and TS-CL (P = 0.01) were significantly correlated with changes in NDI. CONCLUSIONS: ACDF surgery involving 3 or more levels under neutral supine position did not significantly change the postoperative cervical alignment, and thus may not significantly affect cervical alignment or HRQOL.
BACKGROUND: T1 slope minus C2-7 lordosis (TS-CL) and cervical sagittal alignment reportedly affect health-related quality of life (HRQOL) scores after multilevel posterior cervical fusion surgery. There are no reports of a relationship between cervical alignment and patient outcomes after anterior cervical discectomy and fusion (ACDF) involving 3 or more levels. This study aimed to investigate the relationship between cervical sagittal alignment and patient-reported HRQOL after ACDF involving 3 or more levels. METHODS: Thirty-three patients underwent ACDF involving 3 or more levels for cervical stenosis, cervical degenerative disorder, or ossification of the posterior longitudinal ligament (February 2006-April 2015). Mean follow-up duration was 57.6 ± 33.2 months. Radiographic measurements included C0-2 lordosis, C2-7 lordosis, C2-7 sagittal vertical axis (SVA), T1 slope, and T1 slope minus cervical lordosis (TS-CL). Clinical outcomes were evaluated by Neck Disability Index (NDI) and visual analog scale (VAS) scores. RESULTS: There were significant correlations between C2-7 lordosis and T1 slope (r = 0.581, P = 0.004), and between C2-7 lordosis and TS-CL (r = -0.579, P = 0.004). C2-7 lordosis, C2-7 SVA, and TS-CL had no significant correlations with NDI or VAS score after surgery. C2-7 SVA was not significantly different before and after surgery. Postoperative TS-CL (P = 0.01) and changes in T1 slope (P = 0.028) and TS-CL (P = 0.01) were significantly correlated with changes in NDI. CONCLUSIONS: ACDF surgery involving 3 or more levels under neutral supine position did not significantly change the postoperative cervical alignment, and thus may not significantly affect cervical alignment or HRQOL.
Authors: Xiaoyu Yang; Ronald H M A Bartels; Roland Donk; Mark P Arts; Caroline M W Goedmakers; Carmen L A Vleggeert-Lankamp Journal: Eur Spine J Date: 2019-10-12 Impact factor: 3.134
Authors: Katherine E Pierce; Peter Gust Passias; Avery E Brown; Cole A Bortz; Haddy Alas; Renaud Lafage; Oscar Krol; Dean Chou; Douglas C Burton; Breton Line; Eric Klineberg; Robert Hart; Jeffrey Gum; Alan Daniels; Kojo Hamilton; Shay Bess; Themistocles Protopsaltis; Christopher Shaffrey; Frank A Schwab; Justin S Smith; Virginie Lafage; Christopher Ames Journal: J Craniovertebr Junction Spine Date: 2021-09-08
Authors: Peter Gust Passias; Katherine E Pierce; Avery E Brown; Cole A Bortz; Haddy Alas; Renaud Lafage; Virginie Lafage; Breton Line; Eric O Klineberg; Douglas C Burton; Robert Hart; Alan H Daniels; Shay Bess; Bassel Diebo; Themistocles Protopsaltis; Robert Eastlack; Christopher I Shaffrey; Frank J Schwab; Justin S Smith; Christopher Ames Journal: J Craniovertebr Junction Spine Date: 2021-06-10