Research Article

Clinical Correlation of Change in Sagittal Parameters after Anterior Cervical Microdiscectomy

Volume: 7 Number: 1 April 30, 2021
EN

Clinical Correlation of Change in Sagittal Parameters after Anterior Cervical Microdiscectomy

Abstract

Objective: Cervical radiculopathy is the syndrome of pain and / or sensorimotor deficit caused by compression of the cervical nerve root. Symptoms of cervical radiculopathy in the upper limb are described as pain, numbness, or weakness. Conservative treatment is recommended initially for degenerative cervical radiculopathy. Surgical treatment is recommended in cases where progressive loss of muscle strength does not respond to conservative therapy. Many radiographic parameters are used to define the sagittal alignment of the cervical spine. This variation contrasts with the assessment of caudal spine segments where there are more established guides for measuring deformity angles. The aim of this study is to evaluate the effect of anterior cervical discectomy and fusion, which are widely used in spinal surgery practice, on cervical sagittal alignment.
Methods: We retrospectively evaluated 33 patients who were operated with anterior cervical discectomy and fusion technique with the diagnosis of single level degenerative cervical disc hernia after an average of 3 months of follow-up period. For radiological evaluation, we analyzed the C2-C7 lordosis angles, the anterior and posterior disc heights at the operating level on lateral scoliosis radiographs, preoperatively and at 3rd month postoperatively. Japanese Orthopedic Association scores and visual analog scale scores were examined to evaluate clinical results.
Results: A statistically significant difference was found between the preoperative radiological sagittal parameters and the postoperative 3rd month (p = 0.001). When the clinical correlation of the findings was examined, a statistically significant difference was found in the Japanese Orthopedic Association scores and visual analog scale scores of the patients measured preoperatively versus 3 months postoperatively (p < 0.001).
Conclusion: Radiological and clinical parameters improve significantly in patients after single level anterior cervical discectomy surgery.

Keywords

cervical disc hernia , microdiscectomy , sagittal lordosis

References

  1. 1.Ames CP, Blondel B, Scheer JK, Schwab FJ, Le Huec JC, Massicotte EM, et al. Cervical radiographical alignment: comprehensive assessment techniques and potential importance in cervical myelopathy. Spine (Phila Pa 1976). 2013;38:149–60.
  2. 2.Korinth MC. Treatment of cervical degenerative disc disease: current status and trends. Zentralbl Neurochir. 2008;69(3):113–24.
  3. 3.Koeppen D, Piepenbrock C, Kroppenstedt S, Cabraja M. The influence of sagittal profile alteration and final lordosis on the clinical outcome of cervical spondylotic myelopathy: a Delta-Omega-analysis. PLoS One. 2017;12:e0174527.
  4. 4.Teraguchi M, Yoshimura N, Hashizume H, Muraki S, Yamada H, Minamide A, et al. Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama spine study. Osteoarthritis Cartilage. 2014;22:104–10.
  5. 5.Cepoiu-Martin, M, Faris P, Lorenzetti D, Prefontaine E, Noseworthy T, Sutherland L. Artificial cervical disc arthroplasty: a systematic review. Spine (Phila Pa 1976). 2011;36(25):1623–33.
  6. 6.Smith GW, Robinson RA. The treatment of certain cervical spine disorders by anterior removal of theintervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40:607–24.
  7. 7.de Bruin F, Ter Horst S, van den Berg R, de Hooge M, van Gaalen F, Fagerli KM, et al. Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences. Skeletal Radiol. 2016;45:375–81.
  8. 8.Takeshima T, Omokawa S, Takaoka T, Masafumi A, Yurito Y, Yoshinori T. Sagittal alignment of cervical exion and extension: lateral radiographic analysis. Spine. 2002;27:E348–55.
  9. 9.Scheer JK, Tang JA, Smith JS, Acosta FL Jr, Protopsaltis TS, Blondel B, et al. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013;19:141–59.
  10. 10.Canavese F, Turcot K, De Rosa V, De Coulon G, Kaelin A. Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Eur Spine J. 2011;20:1141–8.
Vancouver
1.Timur Yıldırım. Clinical Correlation of Change in Sagittal Parameters after Anterior Cervical Microdiscectomy. Mid Blac Sea J Health Sci. 2021 Apr. 1;7(1):64-8. doi:10.19127/mbsjohs.874199