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Cervical sagittal alignment after Prestige LP cervical disc replacement: radiological results and clinical impacts from a single-center experience.

Abstract：

BACKGROUND:Cervical disc replacement (CDR) has been widely used to treat one- and two-level cervical degenerative disc disease. Studies have shown the effectiveness of CDR in preserving range of motion (ROM) and delaying adjacent segment degeneration (ASD). Cervical sagittal alignment is an important factor affecting favorable clinical outcomes in cervical spine surgery. This study aimed to explore whether cervical sagittal alignment can be maintained after CDR and to identify the impact of cervical sagittal alignment on outcomes after CDR. METHODS:This was a single-center, retrospective study. 132 patients who underwent one-level CDR were included. Cervical sagittal alignments, including cervical lordosis (CL), segmental alignment (SA), sagittal vertical axis (SVA), T1 slope (T1s), and T1s minus CL (T1s-CL), were measured. The effects of cervical sagittal alignment on the CDR outcomes were analyzed. Patients were divided into the heterotopic ossification (HO) group and ASD group to determine the potential impacts of cervical sagittal parameters. RESULTS:The cervical sagittal alignment parameters, except for the SVA, were significantly improved after CDR and showed decreasing trends at the last follow-up. Significantly higher CL and T1s were found in patients with better ROM after CDR. SVA ≥ 20 mm increased the risk of anterior HO (odds ratio = 2.945, P = 0.007). Significantly kyphotic SA and lower T1s values were found in the ASD patients than in the non-ASD patients (P < 0.05). Patients with ASD at the inferior level showed significantly worse CL (P < 0.05). CONCLUSION:CDR had limited function of improving cervical sagittal alignment. Poor cervical sagittal alignment after CDR was associated with HO, ASD, and less ROM.

journal_name

BMC Musculoskelet Disord

journal_title

BMC musculoskeletal disorders

authors

Wang X,Meng Y,Liu H,Chen H,Wang B,Hong Y

doi

10.1186/s12891-021-03962-x

subject

Has Abstract

pub_date

2021-01-15 00:00:00

pages

82

issue

1

issn

1471-2474

pii

10.1186/s12891-021-03962-x

journal_volume

22

pub_type

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