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

BMC Musculoskeletal Disorders

Research Article

Dong-Ning Huang¹  Nan-Fang Xu¹  Yu Sun¹  Xiao-Guang Liu¹  Feng Wei¹  Zhong-Jun Liu¹  Mai Li¹  Shao-Bo Wang¹  Miao Yu¹  Liang Jiang¹ 

[1] Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, China;

关键词: Anterior cervical discectomy and fusion (ACDF);    Cervical sagittal alignment;    Spinopelvic sagittal alignment;    Roussouly classification;   

DOI  :  10.1186/s12891-017-1447-y

 received in 2016-10-25, accepted in 2017-02-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAnterior 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.MethodsA 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.ResultsAmong 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.ConclusionThe 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.

【 授权许可】

CC BY   
© The Author(s). 2017