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Anterior Cervical Discectomy and Fusion Alters Whole-Spine Sagittal Alignment

 Jang Hoon Kim  ;  Jeong Yoon Park  ;  Seong Yi  ;  Kyung Hyun Kim  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho 
 YONSEI MEDICAL JOURNAL, Vol.56(4) : 1060-1070, 2015 
Journal Title
Issue Date
Adult ; Aged ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/physiopathology ; Cervical Vertebrae/surgery* ; Cross-Sectional Studies ; Diskectomy* ; Female ; Humans ; Lordosis/etiology ; Lordosis/surgery* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck/surgery ; Radiography ; Retrospective Studies ; Spinal Diseases/complications ; Spinal Diseases/diagnostic imaging ; Spinal Diseases/physiopathology ; Spinal Diseases/surgery* ; Spinal Fusion/methods* ; Spine ; Treatment Outcome ; Young Adult
ACDF ; pelvic parameters ; whole spine sagittal alignment
PURPOSE: Anterior cervical discectomy and fusion (ACDF) has become a common spine procedure, however, there have been no previous studies on whole spine alignment changes after cervical fusion. Our purpose in this study was to determine whole spine sagittal alignment and pelvic alignment changes after ACDF. MATERIALS AND METHODS: Forty-eight patients who had undergone ACDF from January 2011 to December 2012 were enrolled in this study. Cervical lordosis, thoracic kyphosis, lumbar lordosis, sagittal vertical axis (SVA), and pelvic parameters were measured preoperatively and at 1, 3, 6, and 12 months postoperatively. Clinical outcomes were assessed using Visual Analog Scale (VAS) scores and Neck Disability Index (NDI) values. RESULTS: Forty-eight patients were grouped according to operative method (cage only, cage & plate), operative level (upper level: C3/4 & C4/5; lower level: C5/6 & C6/7), and cervical lordosis (high lordosis, low lordosis). All patients experienced significant improvements in VAS scores and NDI values after surgery. Among the radiologic parameters, pelvic tilt increased and sacral slope decreased at 12 months postoperatively. Only the high cervical lordosis group showed significantly-decreased cervical lordosis and a shortened SVA postoperatively. Correlation tests revealed that cervical lordosis was significantly correlated with SVA and that SVA was significantly correlated with pelvic tilt and sacral slope. CONCLUSION: ACDF affects whole spine sagittal alignment, especially in patients with high cervical lordosis. In these patients, alteration of cervical lordosis to a normal angle shortened the SVA and resulted in reciprocal changes in pelvic tilt and sacral slope.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Yi, Seong(이성)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
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