Cervical sagittal parameters were closely related to Neck Disability Index score after anterior cervical decompression and fusion

Abstract

Background: ACDF treatment of CSM is currently recognized as a surgical method with reliable efficacy. However, the cervical radiographic findings in a certain group of patients showed that the symptoms were not completely relieved. This study will investigate the relationship between cervical parameters and prognoses after ACDF surgery. Methods: This study collected cases of CSM treated with ACDF in Zhongda Hospital from May 2014 to June 2018. The investigators recorded gender, age, cervical sagittal parameters, fusion segment, BMI, symptom duration, and NDI score. To compare the changes of parameters after surgery and explore the correlation between each factor and NDI score. Results: Generally, cervical lordosis increased and TS-CL decreased after surgery and during follow-up. Postoperative T1S, SVA and SCA decreased significantly compared to preoperative. T1S was positively correlated with CL (r = 0.245), SVA (r = 0.184), and negatively correlated with SCA (r = − 0.314) and NT (r = − 0.222). The last follow-up NDI score was positively correlated with T1S (r = 0.689), SVA (r = 0.155), TS-CL (r = 0.496), and age (r = 0.194), while negatively correlated with SCA (r = − 0.142). A linear regression model was established with the following formula: NDI = 0.809 × (T1S) − 0.152 × (CL) + 1.962 × (Sex) + 0.110 × (Age). T1S (B = 0.205, P < 0.001), CL (B = − 0.094, P = 0.041), and NT (B = 0.142, P = 0.023) were independent risk factors that affected whether the last follow-up NDI score was greater than preoperative. Conclusions: In ACDF treatment of CSM, there exists a close correlation between cervical sagittal parameters and NDI scores. T1S, CL, sex, and age were linearly dependent on NDI scores. The increase of T1S, NT, and the decrease of CL were risk factors that affected follow-up NDI score greater than preoperative. Reducing T1S is beneficial to clinical recovery.

Evaluation of the effectiveness of surgical treatment using the one-level ACDF method based on changes in the parameters of the sagittal balance of the cervical spine

“…They analysed the interrelationships of the sagittal balance parameters of the cervical spine and showed statistically significant changes in sagittal balance parameters after surgery. The T1 slope was positively correlated with the angle of cervical lordosis (r = 0.245) and SVA (r = 0.184) [17]. The results obtained by the authors confirm the interdependence of the balance parameters, analogically to the relationships observed in the lumbar spine.…”

Analysis between preoperative cervical radiographic parameters represented by the K-line tilt and the short-term prognosis of laminoplasty for posterior longitudinal ligament ossification: A retrospective study

“…This study also demonstrated a moderate predictive effect of preoperative T1 slope on postoperative JOA score. Before this study, Xu ( 23 ) disclosed that T1 slope, gender, and age were all correlated with the prognosis of cervical spine surgery. Furthermore, Kontt ( 24 ) indicated a strong correlation between T1 slope and C2–C7 SVA and that the cervical sagittal is imbalanced when T1-slope was >25° or <13°.…”

The Pre-Operative Duration of Symptoms: The Most Important Predictor of Post-Operative Efficacy in Patients with Degenerative Cervical Myelopathy

“…Recently, an increasing number of studies have compared the cervical sagittal parameters [ 2 , 3 , 4 ]. Xu Y [ 2 ] found that an increase in the T1S and NT and a decrease in the CL were risk factors affecting the post-operative NDI score.…”

“…Recently, an increasing number of studies have compared the cervical sagittal parameters [ 2 , 3 , 4 ]. Xu Y [ 2 ] found that an increase in the T1S and NT and a decrease in the CL were risk factors affecting the post-operative NDI score. Kato M [ 3 ] found that after a laminoplasty, patients with C2-7SVA ≥ 35 mm will have a poor quality of life and severe neck pain.…”