Academic Journal
Early radiographic outcomes after anterior cervical discectomy and fusion with anatomic versus lordotic cages
| العنوان: | Early radiographic outcomes after anterior cervical discectomy and fusion with anatomic versus lordotic cages |
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| المؤلفون: | Nadeem N. Al-Adli, BS, Siri Tummala, BA, Michael C. Oh, MD, PhD |
| المصدر: | North American Spine Society Journal, Vol 17, Iss , Pp 100292- (2024) |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2024 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Cervical sagittal alignment, Cervical lordosis, T1 slope, T1 slope minus cervical lordosis, Anterior cervical discectomy and fusion, Interbody implant shape, Orthopedic surgery, RD701-811, Neurology. Diseases of the nervous system, RC346-429 |
| الوصف: | Background: Anterior cervical discectomy and fusion (ACDF) interbody implants are shaped anatomically, with a convex superior aspect, or lordotically, with an angle and flat surfaces. However, the effect of implant shape on cervical sagittal balance (CSB) is not well described. Methods: Of the 192 cases reviewed from 2018 to 2019, 118 were included with matching pre- and postoperative imaging. Cases were categorized by interbody implant type (anatomic or lordotic) and number of levels fused (1-level, 2-level, etc.). SurgiMap was used to measure cervical lordosis (CL), C2–C7 sagittal vertical axis (cSVA), T1 slope (T1S), and T1S minus CL (T1S-CL) on pre- and postoperative imaging. Pre- and postoperative parameters were compared within and between each cohort. Change in CL (ΔCL), cSVA (ΔcSVA), and T1S-CL (ΔT1S-CL) were calculated as the difference between pre- and postoperative values and were compared accordingly (1) anatomic versus lordotic and (2) 1-level versus 2-level versus 3-level fusion. Results: Thirty-nine (33.1%), 57 (48.3%), and 22 (18.6%) cases comprised the anatomic, lordotic, and mixed (anatomic and lordotic) groups, respectively. ACDFs improved CL and T1S-CL by 5.71° (p<.001) and 3.32° (p<.01), respectively. CL was improved in the lordotic (5.27°; p<.01) and anatomic (4.57°; p<.01) groups, while only the lordotic group demonstrated improvement in T1S-CL (3.4°; p=.02). There were no differences in ΔCL (p=.70), ΔcSVA (p=.89), or ΔT1S-CL (p=.1) between the groups. Two- and 3-level fusions improved CL by 7.48° (p<.01) and 9.62° (p<.01), and T1S-CL by 4.43° (p<.01) and 5.96° (p<.01), respectively. Conclusions: Overall, ACDFs significantly improved CL and T1S-CL however, there were no differences in CSB correction between the anatomic and lordotic groups. Two- and 3-level fusions more effectively improved CL (vs. single-level) and T1S-CL (vs. 3-level). These results suggest that implants should continue to be personalized to the patient's anatomy, however, future research is ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2666-5484 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S266654842300094X; https://doaj.org/toc/2666-5484; https://doaj.org/article/a1c45731fdeb444fa36d25fcb1c9a755 |
| DOI: | 10.1016/j.xnsj.2023.100292 |
| الاتاحة: | https://doi.org/10.1016/j.xnsj.2023.100292 https://doaj.org/article/a1c45731fdeb444fa36d25fcb1c9a755 |
| رقم الانضمام: | edsbas.FEB163ED |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 26665484 |
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| DOI: | 10.1016/j.xnsj.2023.100292 |