Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Abstract Background To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s). M...

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Main Authors: Yuming Huang, Zhibin Lan, Weihong Xu
Format: Article
Language:English
Published: BMC 2019-01-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-018-2378-y
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author Yuming Huang
Zhibin Lan
Weihong Xu
author_facet Yuming Huang
Zhibin Lan
Weihong Xu
author_sort Yuming Huang
collection DOAJ
description Abstract Background To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s). Methods In total, 42 patients with complete radiographic measurements following ACHDF in the Spine Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2017 were retrospectively analysed. Radiographic measurements included C2–7 lordosis, T1 s, C2–7 sagittal vertical axis (SVA), cervical tilting and cranial tilting. The neck disability index (NDI) was used to evaluate the HRQOL. Spearman’s correlation coefficients were calculated between pairs of cervical sagittal parameters and NDI scores. Results Preoperative NDI scores were correlated with preoperative T1 s (r = 0.413); follow-up NDI scores were correlated with follow-up T1 s (r = 0.534). The regression analysis indicated that a preoperative T1 s value of 42.36° corresponded to a preoperative NDI score of 25 (r2 = 0.171, P < 0.001). A follow-up T1 s value of 48.61° corresponded to a follow-up NDI score of 25 (r2 = 0.421, P < 0.01). The differences in C2–7 SVA and cranial tilting before and after the operation were statistically significant (P < 0.05). Conclusion This study showed that the sagittal balance of the cervical vertebrae changed significantly after ACHDF, showing a forward trend. The sagittal parameters after ACHDF were related to clinical prognosis. An excessive T1 s can be considered a risk factor. The T1 s could provide a reference value to determine the correction of the sagittal balance of the cervical spine.
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spelling doaj.art-d302b610e072448eacae3883af6ae6cc2022-12-21T18:21:56ZengBMCBMC Musculoskeletal Disorders1471-24742019-01-012011810.1186/s12891-018-2378-yAnalysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathyYuming Huang0Zhibin Lan1Weihong Xu2Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Fujian Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Fujian Medical UniversityAbstract Background To investigate the relationships between sagittal parameters and health-related quality of life (HRQOL) scores following anterior cervical hybrid decompression and fusion (ACHDF) of multilevel cervical spondylotic myelopathy (CSM) and to study the impact of the T1 slope (T1 s). Methods In total, 42 patients with complete radiographic measurements following ACHDF in the Spine Surgery Department of the First Affiliated Hospital of Fujian Medical University from August 2014 to January 2017 were retrospectively analysed. Radiographic measurements included C2–7 lordosis, T1 s, C2–7 sagittal vertical axis (SVA), cervical tilting and cranial tilting. The neck disability index (NDI) was used to evaluate the HRQOL. Spearman’s correlation coefficients were calculated between pairs of cervical sagittal parameters and NDI scores. Results Preoperative NDI scores were correlated with preoperative T1 s (r = 0.413); follow-up NDI scores were correlated with follow-up T1 s (r = 0.534). The regression analysis indicated that a preoperative T1 s value of 42.36° corresponded to a preoperative NDI score of 25 (r2 = 0.171, P < 0.001). A follow-up T1 s value of 48.61° corresponded to a follow-up NDI score of 25 (r2 = 0.421, P < 0.01). The differences in C2–7 SVA and cranial tilting before and after the operation were statistically significant (P < 0.05). Conclusion This study showed that the sagittal balance of the cervical vertebrae changed significantly after ACHDF, showing a forward trend. The sagittal parameters after ACHDF were related to clinical prognosis. An excessive T1 s can be considered a risk factor. The T1 s could provide a reference value to determine the correction of the sagittal balance of the cervical spine.http://link.springer.com/article/10.1186/s12891-018-2378-yACHDFSagittal alignmentC2–7 lordosis; C2–7 SVAT1 slope; cervical tilting
spellingShingle Yuming Huang
Zhibin Lan
Weihong Xu
Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
BMC Musculoskeletal Disorders
ACHDF
Sagittal alignment
C2–7 lordosis; C2–7 SVA
T1 slope; cervical tilting
title Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
title_full Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
title_fullStr Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
title_full_unstemmed Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
title_short Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy
title_sort analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical spondylotic myelopathy
topic ACHDF
Sagittal alignment
C2–7 lordosis; C2–7 SVA
T1 slope; cervical tilting
url http://link.springer.com/article/10.1186/s12891-018-2378-y
work_keys_str_mv AT yuminghuang analysisofsagittalalignmentparametersfollowinganteriorcervicalhybriddecompressionandfusionofmultilevelcervicalspondyloticmyelopathy
AT zhibinlan analysisofsagittalalignmentparametersfollowinganteriorcervicalhybriddecompressionandfusionofmultilevelcervicalspondyloticmyelopathy
AT weihongxu analysisofsagittalalignmentparametersfollowinganteriorcervicalhybriddecompressionandfusionofmultilevelcervicalspondyloticmyelopathy