Analysis of Cervical Sagittal Balance in Treating Cervical Spondylotic Myelopathy: 1-Level Anterior Cervical Corpectomy and Fusion Versus 2-Level Anterior Cervical Discectomy and Fusion

Zhou, Pinghui; Zong, Lujie; Wu, Qian; Ye, Yuchen; Yang, Huilin; Zhang, Changchun; Wang, Shenghao

doi:10.12659/msm.923748

Cited by 6 publications

(10 citation statements)

References 29 publications

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“…Cervical spine is a whole alignment, in order to maintain the horizontal gaze, a certain linkage relationship exists between each other of the cervical sagittal parameters. Previous studies have confirmed that C2‐7 Cobb is associated with T1S, C0‐2 Cobb, TIA, and C2‐7 SVA, and T1S had the strongest correlation with C2‐7 Cobb 17,18,25–28 . In this study, we found that C2‐7 Cobb was correlated with the five parameters other than NT, and T1S had the greatest influence on C2‐7 Cobb, which was consistent with previous studies.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have confirmed that C2-7 Cobb is associated with T1S, C0-2 Cobb, TIA, and C2-7 SVA, and T1S had the strongest correlation with C2-7 Cobb. 17,18,[25][26][27][28] In this study, we found that C2-7 Cobb was correlated with the five parameters other than NT, and T1S had the greatest influence on C2-7 Cobb, which was consistent with previous studies. However, the effect of the CBVA deviation, with an acceptable range of À1.5 to 5.8 , on cervical curvature has been confirmed.…”

Section: The Variation Trend With Age Of Cervical Sagittal Alignment ...supporting

confidence: 92%

“…Currently, there were three different views: no age difference in subaxial cervical lordosis angle (C2‐7 Cobb), 22 decreasing with age, 17 or increasing with age. 15 , 18 , 19 , 23 , 24 , 25 And the prevailing view supported the latter. Yukawa et al .…”

Section: Discussionmentioning

confidence: 91%

“…Located on the top of the spine, the cervical spine alignment had obvious age differences. Currently, there were three different views: no age difference in subaxial cervical lordosis angle (C2‐7 Cobb), 22 decreasing with age, 17 or increasing with age 15,18,19,23–25 . And the prevailing view supported the latter.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there were three different views: no age difference in subaxial cervical lordosis angle (C2-7 Cobb), 22 decreasing with age, 17 or increasing with age. 15,18,19,[23][24][25] And the prevailing view supported the latter. Yukawa et al retroactively analyzed the cervical sagittal parameters of 1230 healthy volunteers by cervical lateral radiography and found that the C2-7 Cobb increased with age.…”

Section: The Variation Trend With Age Of Cervical Sagittal Alignment ...mentioning

confidence: 94%

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The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

Guo

Yang

et al. 2022

Orthopaedic Surgery

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Objective At present, the true sagittal alignment of the cervical spine is uncertain, resulting in no standard reference for subaxial cervical surgery. So, we aimed to explore the age difference of normal cervical sagittal alignment and to further investigate the mid‐and long‐term changes of sagittal alignment after subaxial cervical spine surgery. Materials and Methods This was a retrospective study and 1223 asymptomatic volunteers and 79 patients undergoing subaxial cervical spine surgery were retrospectively reviewed in total. Asymptomatic volunteers and patients were divided into six subgroups: 20–29, 30–39, 40–49, 50–59, 60–69 and ≥70 groups. The age difference and trend with age of cervical sagittal parameters of asymptomatic volunteers were assessed by cervical lateral radiography and analyzed by ANOVA test, and the regression equation of C2‐7 Cobb was established via multiple linear regression. Based on the C2‐7 Cobb regression equations of different ages, the theoretical value, deviation value, loss value of the C2‐7 Cobb, and JOA recovery rate of patients were calculated, and the correlation among the loss value, deviation value of the C2‐7 Cobb, and JOA recovery rate of the 79 patients was evaluated by Pearson correlation analysis. Results For the asymptomatic volunteers, the C0‐2 Cobb decreased gradually with increasing age. The C2‐7 Cobb, C2‐7 SVA, T1S, NT, and TIA increased gradually with increasing age. The CBVA fluctuated with increasing age. T1S demonstrated a moderate correlation with C2‐7 Cobb ( r = 0.60, p < 0.01); C0‐2 Cobb, C2‐7 SVA, CBVA, and TIA demonstrated a fair correlation with C2‐7 Cobb ( r = −0.30, −0.33, 0.41, 0.40, p < 0.01); age demonstrated a poor correlation with C2‐7 Cobb ( r = 0.19, p < 0.01). The regression equations of C2‐7 Cobb were established using C0‐2 Cobb, C2‐7 SVA, CBVA, and T1S. For the patients with subaxial cervical spine surgery, the loss of C2‐7 Cobb was moderately correlated with the deviation of C2‐7 Cobb ( r = 0.33, p < 0.01). Conclusion The age difference of cervical sagittal alignment was obvious, and the C2‐7 Cobb increased with age especially. The closer the postoperative C2‐7 Cobb was to the theoretical value of corresponding age, the smaller the loss of correction angle was, and the better the mid‐ and long‐term outcomes. The personalized sagittal reconstruction should be performed according to age difference for subaxial cervical spine surgery.

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Section: Discussionsupporting

confidence: 92%

Section: The Variation Trend With Age Of Cervical Sagittal Alignment ...supporting

confidence: 92%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: The Variation Trend With Age Of Cervical Sagittal Alignment ...mentioning

confidence: 94%

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The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

Guo

Yang

et al. 2022

Orthopaedic Surgery

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Surgical treatment was desirable to improve neuromuscular function in patients with sustained 3 years fracture‐dislocation of lower cervical spine: A case report

Yuan

Wang

et al. 2022

Ibrain

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To investigate the changes in neuromuscular function of anterior approach combined with subtotal vertebral body resection and titanium mesh cage (TMC) internal fixation for the old fracture‐dislocated lower cervical spine. A 56‐year‐old female was admitted to the hospital with neck pain and numbness of the left upper extremity for 3 years due to a fall injury from a height, which worsened for 20 days. Although 3 years had passed, the patient still had significant left limb numbness and decreased muscle strength. Eventually, the patient was diagnosed with the old fracture‐dislocation type injury of C6 and C7. C6 was II‐degree anterior dislocation and the bilateral joint process was locked, C7 was burst fracture, and C5 was spinal cord segment injury. Then, the operation of the anterior approach combined with subtotal vertebral body resection and TMC internal fixation was performed under general anesthesia. Postoperative symptoms were significantly improved. And during five‐year of follow‐up, no adverse reactions and complications were reported. Although cervical fracture and dislocation combined with cervical spinal cord injury had persisted for many years, surgical treatment was necessary. The anterior approach combined with subtotal vertebral body resection and TMC internal fixation was desirable to improve neuromuscular function for the old fracture‐dislocation of the lower cervical spine, which has some guiding effects on the clinical treatment.

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A Meta-Analysis of Surgical Outcomes in 25727 Patients Undergoing Anterior Cervical Discectomy and Fusion or Anterior Cervical Corpectomy and Fusion for Cervical Deformity

Barot,

Ruiz-Cardozo,

Singh

et al. 2024

Global Spine Journal

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Study Design Systematic Review. Objectives To evaluate which cervical deformity correction technique between anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) produces better clinical, radiographic, and operative outcomes. Methods We conducted a meta-analysis comparing studies involving ACDF and ACCF. Adult patients with either original or previously treated cervical spine deformities were included. Two independent reviewers categorized extracted data into clinical, radiographic, and operative outcomes, including complications. Clinical assessments included patient-reported outcomes; radiographic evaluations examined C2-C7 Cobb angle, T1 slope, T1-CL, C2-7 SVA, and graft stability. Surgical measures included surgery duration, blood loss, hospital stay, and complications. Results 26 studies (25727 patients) met inclusion criteria and were extracted. Of these, 14 studies (19077 patients) with low risk of bias were included in meta-analysis. ACDF and ACCF similarly improve clinical outcomes in terms of JOA and NDI, but ACDF is significantly better at achieving lower VAS neck scores. ACDF is also more advantageous for improving cervical lordosis and minimizing the incidence of graft complications. While there is no significant difference between approaches for most surgical complications, ACDF is favorable for reducing operative time, intraoperative blood loss, and length of hospital stay. Conclusions While both techniques benefit cervical deformity patients, when both techniques are feasible, ACDF may be superior with respect to VAS neck scores, cervical lordosis, graft complications and certain perioperative outcomes. Further studies are recommended to address outcome variability and refine surgical approach selection.

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Analysis of Cervical Sagittal Balance in Treating Cervical Spondylotic Myelopathy: 1-Level Anterior Cervical Corpectomy and Fusion Versus 2-Level Anterior Cervical Discectomy and Fusion

Cited by 6 publications

References 29 publications

The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

Surgical treatment was desirable to improve neuromuscular function in patients with sustained 3 years fracture‐dislocation of lower cervical spine: A case report

A Meta-Analysis of Surgical Outcomes in 25727 Patients Undergoing Anterior Cervical Discectomy and Fusion or Anterior Cervical Corpectomy and Fusion for Cervical Deformity

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