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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 Musculoskelet Disord. 2017 02 20; 18(1):87.BM

Abstract

BACKGROUND

Anterior 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.

METHODS

A 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.

RESULTS

Among 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.

CONCLUSION

The 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.

Authors+Show Affiliations

Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China. puth_lxg@163.com.Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28219364

Citation

Huang, Dong-Ning, et al. "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, vol. 18, no. 1, 2017, p. 87.
Huang DN, Yu M, Xu NF, et al. 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 Musculoskelet Disord. 2017;18(1):87.
Huang, D. N., Yu, M., Xu, N. F., Li, M., Wang, S. B., Sun, Y., Jiang, L., Wei, F., Liu, X. G., & Liu, Z. J. (2017). 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, 18(1), 87. https://doi.org/10.1186/s12891-017-1447-y
Huang DN, et al. 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 Musculoskelet Disord. 2017 02 20;18(1):87. PubMed PMID: 28219364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Huang,Dong-Ning, AU - Yu,Miao, AU - Xu,Nan-Fang, AU - Li,Mai, AU - Wang,Shao-Bo, AU - Sun,Yu, AU - Jiang,Liang, AU - Wei,Feng, AU - Liu,Xiao-Guang, AU - Liu,Zhong-Jun, Y1 - 2017/02/20/ PY - 2016/10/25/received PY - 2017/02/08/accepted PY - 2017/2/22/entrez PY - 2017/2/22/pubmed PY - 2018/2/22/medline KW - Anterior cervical discectomy and fusion (ACDF) KW - Cervical sagittal alignment KW - Roussouly classification KW - Spinopelvic sagittal alignment SP - 87 EP - 87 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 18 IS - 1 N2 - BACKGROUND: Anterior 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. METHODS: A 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. RESULTS: Among 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. CONCLUSION: The 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. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/28219364/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_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1447-y DB - PRIME DP - Unbound Medicine ER -