Changes of cervical sagittal parameters of patients in different age groups with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion

doi:10.3969/j.issn.1006-7795.2023.04.019

Abstract

Abstract: Objective To evaluate the changes of the cervical sagittal alignment and the clinical effect in different age groups with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion (ACDF). Method Seventy patients with cervical spondylotic radiculopathy from January 2019 to December 2020 were selected and underwent ACDF surgery. The demographic information and surgical data of the patients were recorded. The following sagittal parameters of the cervical spine were measured before operation, after operation and during the last follow-up: the occipital C2 angle (OC2), C2-7 lordosis (CL), T1 slope (T1S), the cervical sagittal vertical axis (cSVA) and segmental angle (SA). The changes of the parameters after ACDF were analyzed. The samples were divided into two groups according to whether they were less than 60 years old or not, and the differences between the elderly and the non-elderly patients were compared. The NDI (Neck Disability Index) and the improvement rate of the modified Japanese orthopaedic association scores for assessment of cervical myelopathy(mJOA) at the last follow-up were used as prognostic evaluation indexes to analyze the influence of the cervical sagittal parameters on the prognosis. Result The correlation analysis of preoperative parameters showed that SA was positively correlated with CL and T1S. CL was negatively correlated with OC2, T1S-CL and cSVA. OC2 was positively correlated with T1S-CL. T1S was positively correlated with cSVA. The above correlation also existed at the last follow-up. The correlation analysis of postoperative parameter changes showed that △CL was positively correlated with △SA and △T1S, and negatively correlated with △T1S-CL and △cSVA. △CL and △SA were negatively correlated with △T1S-CL and △cSVA, while △T1S was positively correlated with △T1S-CL and △cSVA. There was a negative correlation between △OC2 and △cSVA. In the comparison between 38 non-elderly patients (< 60) and 32 elderly patients (≥60), we found that the loss of CL was more serious in the elderly group, and cSVA has a tendency to increase after the operation. Conclusion OC2 may be involved in the sagittal compensation of the cervical degeneration and would influence the cervical postoperative recovery. The poor improvement of the sagittal alignment and the loss of cervical kyphosis angle in the elderly patients during the last follow-up may be the reason for the poor cervical function evaluation after surgery.

Key words: cervical spine, cervical spondylotic radiculopathy, sagittal alignment, elderly patients

CLC Number:

R684

Shi Bin, Liu Chengxin, Wang Shuaikang, Li Xiangyu, Pan Fumin, Zhu Weiguo, Lu Shibao. Changes of cervical sagittal parameters of patients in different age groups with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion[J]. Journal of Capital Medical University, 2023, 44(4): 620-628.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.04.019

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I4/620

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