Impact of Nonlordotic Sagittal Alignment on Short-term Outcomes of Cervical Disc Replacement

Overview

Journal Neurospine

Date 2020 Oct 6

PMID 33022164

Citations 5

Authors

Jung Kee Mok

Avani S Vaishnav

Chirag Chaudhary

R Kiran Alluri

Ryan Lee

Hikari Urakawa

Kosuke Sato

Darren A Chen

Catherine Himo Gang

Russel Huang

Todd J Albert

Sheeraz A Qureshi

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate outcomes of cervical disc replacement (CDR) in patients with nonlordotic alignment.

Methods: Patients who underwent CDR were retrospectively reviewed and divided into 3 cohorts: (1) neutral/lordotic segmental and C2-7 Cobb angle (L), (2) nonlordotic segmental Cobb angle, lordotic C2-7 Cobb angle (NL-S), and (3) nonlordotic segmental and C2-7 Cobb angle (NL-SC). Radiographic and patient-reported outcomes (PROMs) were compared.

Results: One-hundred five patients were included (L: 37, NL-S: 30, NL-SC: 38). A significant gain in segmental lordosis was seen in all cohorts at < 6 months (L: -1.90° [p = 0.007]; NL-S: -5.16° [p < 0.0001]; NL-SC: -6.00° [p < 0.0001]) and ≥ 6 months (L: -2.07° [p = 0.031; NL-S: -6.04° [p < 0.0001]; NL-SC: -6.74° [p < 0.0001]), with greater lordosis generated in preoperatively nonlordotic cohorts (p < 0.0001). C2-7 lordosis improved in the preoperatively nonlordotic cohort (NL-SC: 8.04°) at follow-up of < 6 months (-4.15°, p = 0.003) and ≥ 6 months (-6.40°, p = 0.003), but not enough to create lordotic alignment (< 6 months: 3.89°; ≥ 6 months: 4.06°). All cohorts showed improvement in Neck Disability Index, visual analogue scale (VAS) neck, and VAS arm, without significant difference among groups in the amount of improvement ( ≥ 6-month PROMs follow-up = 69%).

Conclusion: In patients without major kyphotic deformity, CDR has the potential to generate and maintain lordosis and improve PROMs in the short-term, and can be an effective treatment option for patients with nonlordotic alignment.

Citing Articles

Clinical Effectiveness of Artificial Disc Replacement in Comparison With Anterior Cervical Discectomy and Fusion in the Patients With Cervical Myelopathy: Systematic Review and Meta-analysis.

Lee J, Lee Y, Chang M, Lee J Neurospine. 2023; 20(3):1047-1060.

PMID: 37798997 PMC: 10562247. DOI: 10.14245/ns.2346498.249.

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience.

Chen S, Deng Y, Liu H, Wu T, Huang K, He J J Orthop Surg Res. 2023; 18(1):345.

PMID: 37165448 PMC: 10170693. DOI: 10.1186/s13018-023-03819-0.

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis.

Paik S, Choi Y, Chung C, Won Y, Park S, Yang S PLoS One. 2023; 18(2):e0281926.

PMID: 36809260 PMC: 9942978. DOI: 10.1371/journal.pone.0281926.

Association of Craniocervical Sagittal Alignment With the Outcomes of Cervical Disc Replacement.

Shen Y, Yang Y, Hong Y, Ding C, Rong X, Meng Y Global Spine J. 2022; 14(3):846-855.

PMID: 36044545 PMC: 11192106. DOI: 10.1177/21925682221124531.

Commentary on "Impact of Nonlordotic Sagittal Alignment on Short-term Outcomes of Cervical Disc Replacement".

Zhang K, Liu H, Wu T Neurospine. 2021; 18(2):413-414.

PMID: 34218625 PMC: 8255763. DOI: 10.14245/ns.2142442.221.

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