Abstract
Anterior cervical discectomy and fusion (ACDF) is an effective method in treating cervical sagittal imbalance and spine deformations. The aim of this work was to assess whether changes of the Cobb angle, sagittal vertical axis (SVA) and T1 slope parameters affect the outcomes of surgical treatment. A prospective study was performed in 30 patients qualified for surgical treatment for cervical degenerative disc disease. The ACDF was performed on 2 levels. Every patient underwent an X-ray examination before surgery and 3 months after the procedure. The following parameters were assessed: the T1 slope, the angle of cervical lordosis, the SVA distance, quality of life assessed using the Neck Disability Index (NDI), and perceived pain measurement assessed using the Visual Analogue Scale (VAS). The cervical lordosis angle significantly changed (p < 0.01) to an average of 11.52°. The SVA C2-C7 distance significantly decreased (p < 0.001) to an average of 21.06 mm. The value of the T1 slope angle did not change significantly before and after surgery (p = 0.706). After surgery, statistically significant improvement was achieved on the NDI scale for neck pain (p < 0.001) to an average of 9. The NDI score significantly decreased over time (p < 0.001), and this change was significantly related to the increased Cobb angle (p = 0.036). Improvement in cervical lordosis C2-C7 can improve the outcomes of surgical treatment. Preoperative analysis of X-rays and sagittal balance parameters may be beneficial for treatment outcomes.
Highlights
Anterior cervical discectomy and fusion (ACDF) is an effective method in treating cervical sagittal imbalance and spine deformations
The Neck Disability Index (NDI) score significantly decreased over time (p < 0.001), and this change was significantly related to the increased Cobb angle (p = 0.036)
The improvement in cervical lordosis C2–C7 can improve the outcomes of surgical treatment
Summary
Anterior cervical discectomy and fusion (ACDF) is an effective method in treating cervical sagittal imbalance and spine deformations. Anterior cervical discectomy and fusion (ACDF), which was first described by Smith and Robinson, is considered one of the most effective surgical treatments for cervical discopathy, as it provides safe access to disc spaces from the C3 to C7 levels.[1] It is a very effective method for treating spinal canal stenosis, spinal cord and nerve root compression, and when correcting cervical spine deformities with improvement of alignment of the segment in the sagittal projection.[2] In Poland, the technique of the anterior approach to the cervical spine was first applied by Jan Haftek in 1967. The appropriate level of the spine is determined with the use of the C-arm. To restore its height and stabilize the spine, a cage implant is placed into the intervertebral space under C-arm guidance.[3,4]
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