THE EFFECT OF PREOPERATIVE CERVICAL SAGITTAL ALIGNMENT ON POSTOPERATIVE SURGICAL RESULTS IN PATIENTS TREATED BY ANTERIOR CERVICAL DISCECTOMY AND FUSION
Journal Title: Journal of Turkish Spinal Surgery - Year 2019, Vol 30, Issue 4
Abstract
Objective: Cervical degenerative disc diseases arise in some degenerative settings. These degenerative cervical changes may be a consequence of cervical sagittal malalignment. The aim of this study is to assess preoperative profile and postoperative changes in cervical sagittal profiles; and correlation between these changes and surgical outcomes in patients undergoing anterior cervical discectomy and fusion. Materials and Methods: Eighty consecutive men and women who underwent anterior cervical discectomy and fusion (ACDF) were enrolled in the study. Cervical alignment was classified into 4 types-lordotic, flat, sigmoid, and kyphotic. Lordosis angle was measured by the Cobb method. Segmental angle at the level of discectomy was measured. Preoperative, early postoperative, and the 1st and 3rd month visual analog scale results were recorded. Improvement of cervical sagittal alignment and visual analogue scale (VAS) changes were compared statistically. Results: The median preoperative VAS score was 7. This score decreased to 1 as a median immediately after operation. This change was statistically significant. Sagittal alignment changes in early postoperative period were not statistically significant despite the observation of improvement in some patients. However, after 1st and 3rd months, results showed significant improvements. Conclusion: ACDF is an effective treatment of cervical degenerative disc diseases (CDDD). Decompression is still the main issue of the degenerative cervical diseases. Sagittal alignment may be restored by using lordotic cages. Patients with F sagittal shape may tend to develop CDDD more than N sagittal profile. There is a correlation between clinical improvement and radiologic improvement.
Authors and Affiliations
Canan SUBAŞI, Cengiz TUNCER, Uygur ER
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