The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion
Objective Subsidence following anterior cervical discectomy and fusion (ACDF) may lead to disruptions of cervical alignment and lordosis. The purpose of this study was to evaluate the effect of subsidence on segmental, regional, and global lordosis. Methods This was a retrospective cohort study perf...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2022-12-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2244750-375.pdf |
| _version_ | 1797329597763682304 |
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| author | Akiro H. Duey Christopher Gonzalez Eric A. Geng Pierce J. Ferriter Jr Ashley M. Rosenberg Ula N. Isleem Bashar Zaidat Paul M. Al-Attar Jonathan S. Markowitz Jun S. Kim Samuel K. Cho |
| author_facet | Akiro H. Duey Christopher Gonzalez Eric A. Geng Pierce J. Ferriter Jr Ashley M. Rosenberg Ula N. Isleem Bashar Zaidat Paul M. Al-Attar Jonathan S. Markowitz Jun S. Kim Samuel K. Cho |
| author_sort | Akiro H. Duey |
| collection | DOAJ |
| description | Objective Subsidence following anterior cervical discectomy and fusion (ACDF) may lead to disruptions of cervical alignment and lordosis. The purpose of this study was to evaluate the effect of subsidence on segmental, regional, and global lordosis. Methods This was a retrospective cohort study performed between 2016–2021 at a single institution. All measurements were performed using lateral cervical radiographs at the immediate postoperative period and at final follow-up greater than 6 months after surgery. Associations between subsidence and segmental lordosis, total fused lordosis, C2–7 lordosis, and cervical sagittal vertical alignment change were determined using Pearson correlation and multivariate logistic regression analyses. Results One hundred thirty-one patients and 244 levels were included in the study. There were 41 one-level fusions, 67 two-level fusions, and 23 three-level fusions. The median follow-up time was 366 days (interquartile range, 239–566 days). Segmental subsidence was significantly negatively associated with segmental lordosis change in the Pearson (r = -0.154, p = 0.016) and multivariate analyses (beta = -3.78; 95% confidence interval, -7.15 to -0.42; p = 0.028) but no associations between segmental or total fused subsidence and any other measures of cervical alignment were observed. Conclusion We found that subsidence is associated with segmental lordosis loss 6 months following ACDF. Surgeons should minimize subsidence to prevent long-term clinical symptoms associated with poor cervical alignment. |
| first_indexed | 2024-03-08T07:07:48Z |
| format | Article |
| id | doaj.art-7f6786358bdf4f6ea936f96d651ce20d |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:07:48Z |
| publishDate | 2022-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-7f6786358bdf4f6ea936f96d651ce20d2024-02-03T04:00:50ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912022-12-0119492793410.14245/ns.2244750.3751336The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and FusionAkiro H. Duey0Christopher Gonzalez1Eric A. Geng2Pierce J. Ferriter Jr3Ashley M. Rosenberg4Ula N. Isleem5Bashar Zaidat6Paul M. Al-Attar7Jonathan S. Markowitz8Jun S. Kim9Samuel K. Cho10 Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USAObjective Subsidence following anterior cervical discectomy and fusion (ACDF) may lead to disruptions of cervical alignment and lordosis. The purpose of this study was to evaluate the effect of subsidence on segmental, regional, and global lordosis. Methods This was a retrospective cohort study performed between 2016–2021 at a single institution. All measurements were performed using lateral cervical radiographs at the immediate postoperative period and at final follow-up greater than 6 months after surgery. Associations between subsidence and segmental lordosis, total fused lordosis, C2–7 lordosis, and cervical sagittal vertical alignment change were determined using Pearson correlation and multivariate logistic regression analyses. Results One hundred thirty-one patients and 244 levels were included in the study. There were 41 one-level fusions, 67 two-level fusions, and 23 three-level fusions. The median follow-up time was 366 days (interquartile range, 239–566 days). Segmental subsidence was significantly negatively associated with segmental lordosis change in the Pearson (r = -0.154, p = 0.016) and multivariate analyses (beta = -3.78; 95% confidence interval, -7.15 to -0.42; p = 0.028) but no associations between segmental or total fused subsidence and any other measures of cervical alignment were observed. Conclusion We found that subsidence is associated with segmental lordosis loss 6 months following ACDF. Surgeons should minimize subsidence to prevent long-term clinical symptoms associated with poor cervical alignment.http://e-neurospine.org/upload/pdf/ns-2244750-375.pdfcervical vertebraeintervertebral discvertebral bodyspinal fusiondiskectomylordosis |
| spellingShingle | Akiro H. Duey Christopher Gonzalez Eric A. Geng Pierce J. Ferriter Jr Ashley M. Rosenberg Ula N. Isleem Bashar Zaidat Paul M. Al-Attar Jonathan S. Markowitz Jun S. Kim Samuel K. Cho The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion Neurospine cervical vertebrae intervertebral disc vertebral body spinal fusion diskectomy lordosis |
| title | The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion |
| title_full | The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion |
| title_fullStr | The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion |
| title_full_unstemmed | The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion |
| title_short | The Effect of Subsidence on Segmental and Global Lordosis at Long-term Follow-up After Anterior Cervical Discectomy and Fusion |
| title_sort | effect of subsidence on segmental and global lordosis at long term follow up after anterior cervical discectomy and fusion |
| topic | cervical vertebrae intervertebral disc vertebral body spinal fusion diskectomy lordosis |
| url | http://e-neurospine.org/upload/pdf/ns-2244750-375.pdf |
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