Does Cervical Alignment Matter? The Effect of 2-level Anterior Cervical Discectomy and Fusion on Sagittal Alignment and Patient-reported Outcomes

This study aimed to determine the change in cervical sagittal balance following 2-level anterior cervical discectomy and fusion (ACDF) and whether the degree of change was associated with improvement in patient-reported outcomes (PROs). Summary of Background Data: Sagittal balance in cervical spine surgery has been recognized as an important surgical goal. However, its influence on clinical outcomes following anterior decompressive procedures remains debatable. Materials and Methods: Patients who underwent primary 2-level ACDF for cervical spondylotic radiculopathy and/or myelopathy were identified from an institutional spine registry. Radiographic measurements were done preoperatively, postoperatively, and at minimum 24 months follow-up. Measurements comprised segmental lordosis (SL), C2−C7 cervical lordosis (CL), C2−C7 sagittal vertical axis, C7 slope (C7S), T1 slope (T1S) and C7 slope minus cervical lordosis (C7S−CL). Disk heights were measured preoperatively and postoperatively. PROs including the Neck Disability Index, Short Form-36, and Visual Analog Scale for neck pain and arm pain were collected preoperatively and at 24 months postoperatively. Results: In total, 90 patients were included. Mean follow-up was 58.6±22.9 months. Significant improvement in all PROs was achieved at 24 months (P
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research