Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion
Degenerative disease of the cervical spine leads to sagittal imbalance, which may affect treatment results. The purpose of this study was to evaluate changes in selected cervical sagittal balance parameters and their effects on subsidence and clinical outcomes of the procedure. This study encompasse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/12/3310 |
| _version_ | 1797381856740507648 |
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| author | Adam Bębenek Maciej Dominiak Bartosz Godlewski |
| author_facet | Adam Bębenek Maciej Dominiak Bartosz Godlewski |
| author_sort | Adam Bębenek |
| collection | DOAJ |
| description | Degenerative disease of the cervical spine leads to sagittal imbalance, which may affect treatment results. The purpose of this study was to evaluate changes in selected cervical sagittal balance parameters and their effects on subsidence and clinical outcomes of the procedure. This study encompassed a total of 95 evaluated patients who underwent anterior cervical discectomy and fusion (ACDF). Selected cervical sagittal balance parameters were assessed using lateral projection X-rays: C2–C7 spinal vertical axis (C2–C7 SVA), spinocranial angle (SCA), C7 slope, C2–C7 lordosis, and the segmental Cobb angle. Measurements were collected the day before, the day after, and 12 months after surgery. Changes in clinical parameters was assessed using the VAS and NDI scales. Subsidence was defined as a loss of intervertebral height of more than 30% of the baseline value. Among all the assessed parameters, only the C2–C7 SVA demonstrated a statistically significant difference between the groups with and without subsidence: 26.03 vs. 21.79 [mm], with <i>p</i> = 0.0182, preoperatively and 27.80 vs. 24.94 [mm], with <i>p</i> = 0.0449, on the day after surgery, respectively. We conclude that higher preoperative and postoperative C2–C7 SVA values might contribute to an elevated risk of implant subsidence. Furthermore, both the SCA and C7 slope could conceivably influence the clinical outcome, respectively impacting pain, as assessed by the VAS and the disability, as evaluated through the NDI scale. |
| first_indexed | 2024-03-08T20:57:30Z |
| format | Article |
| id | doaj.art-34f69ef7855447a3ba88300934ddbec5 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-08T20:57:30Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-34f69ef7855447a3ba88300934ddbec52023-12-22T13:55:16ZengMDPI AGBiomedicines2227-90592023-12-011112331010.3390/biomedicines11123310Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and FusionAdam Bębenek0Maciej Dominiak1Bartosz Godlewski2Department of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed—St. Raphael Hospital, 30-693 Cracow, PolandDepartment of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed—St. Raphael Hospital, 30-693 Cracow, PolandDepartment of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed—St. Raphael Hospital, 30-693 Cracow, PolandDegenerative disease of the cervical spine leads to sagittal imbalance, which may affect treatment results. The purpose of this study was to evaluate changes in selected cervical sagittal balance parameters and their effects on subsidence and clinical outcomes of the procedure. This study encompassed a total of 95 evaluated patients who underwent anterior cervical discectomy and fusion (ACDF). Selected cervical sagittal balance parameters were assessed using lateral projection X-rays: C2–C7 spinal vertical axis (C2–C7 SVA), spinocranial angle (SCA), C7 slope, C2–C7 lordosis, and the segmental Cobb angle. Measurements were collected the day before, the day after, and 12 months after surgery. Changes in clinical parameters was assessed using the VAS and NDI scales. Subsidence was defined as a loss of intervertebral height of more than 30% of the baseline value. Among all the assessed parameters, only the C2–C7 SVA demonstrated a statistically significant difference between the groups with and without subsidence: 26.03 vs. 21.79 [mm], with <i>p</i> = 0.0182, preoperatively and 27.80 vs. 24.94 [mm], with <i>p</i> = 0.0449, on the day after surgery, respectively. We conclude that higher preoperative and postoperative C2–C7 SVA values might contribute to an elevated risk of implant subsidence. Furthermore, both the SCA and C7 slope could conceivably influence the clinical outcome, respectively impacting pain, as assessed by the VAS and the disability, as evaluated through the NDI scale.https://www.mdpi.com/2227-9059/11/12/3310ACDFsubsidencesagittal balance |
| spellingShingle | Adam Bębenek Maciej Dominiak Bartosz Godlewski Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion Biomedicines ACDF subsidence sagittal balance |
| title | Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion |
| title_full | Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion |
| title_fullStr | Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion |
| title_full_unstemmed | Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion |
| title_short | Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion |
| title_sort | cervical sagittal balance impact on clinical outcomes and subsidence in anterior cervical discectomy and fusion |
| topic | ACDF subsidence sagittal balance |
| url | https://www.mdpi.com/2227-9059/11/12/3310 |
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