Objective: To investigate changings of cervical sagittal parameters after anterior discectomy and fusion (ACDF) with lordosis cages. Material and methods: This study includes 55 patients with one and two levels of soft cervical disc hernia who were operated via ACDF with lordosis cage. The study is designated retrospectively. Visual analog scale (VAS) values, cervical lordosis angle, cranial slope and Ctilt were evaluated preoperatively and postoperatively at some certain periods. Changings of these parameters compared statistically. Correlation between VAS values and sagittal parameters were investigated statistically. Results: No statistically significant differences were found between preoperative and postoperative sagittal parameters. Statistical analysis showed that change of VAS values is significant for every level and two levels disk hernia for all postoperative follow-up times (p?0.001). Conclusions: Restoration of cervical sagittal parameters measurements come closer those of normal population values after surgery. However, these changings were not statistically significant. The clinical results of surgical treatment of cervical disc disease generally come before radiological improvement like other areas of spinal surgery. It is expected that statistically significant results can be obtained from long term follow-ups since these parameters approaching the values of normal population in the early postoperative period.
1. Beltsios M, Savvidou O, Mitsiokapa EA, Mavrogenis AF, Kaspiris A, Efstathopoulos N, Papagelopoulos PJ. Sagittal alignment of the cervical spine after neck injury. Eur J Orthop Surg Traumatol 2013; 23 (Suppl-1): S47-51.
2. 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: 1141-1148.
3. Dağlı M, Er U, Şimşek S, Bavbek M. Late results of anterior cervical discectomy and fusion with interbody cages. Asian Spine J 2013; 1: 34-38.
4. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of cervical spine in asymptomatic people. Spine 1986; 11(6): 521-524.
5. Gore DR. Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine 2001; 26: 2463-2466.
6. Gulsen S. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy. Macedonian J Med Sci 2015; 3(2): 215-223.
7. Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br 1994; 76(1): 103-106.
8. Le Huec JC,Demezon H, Aunoble S. Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers. Eur Spine J 2015; 24: 63-71.
9. Huang ZY, Wu AM, Li QL, Lei T, Wang KY, Xu HZ, Ni WF. Comparison of two anterior fusion methods in twolevel cervical spondylosis myelopathy: a meta-analysis. BMJ Open 2014; 4(7): e004581.
10. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine 1994; 19: 1611-1618.
11. Janusz P, Tyrakowski M, Kotwicki T, Siemionow K. Cervical sagittal alignment in Scheuermann disease. Spine 2015; 40(23): E1226-1232.
12. Lee JH, Lee SH. Clinical and radiographic changes after percutaneous endoscopic cervical discectomy: A longterm follow-up. Photomed Laser Surg 2014; 32(12): 663- 668.
13. Peolsson A, Öberg B, Wibault J, Dedering Å, Zsigmond P, Bernfort L, Kammerlind AS, Persson LC, Löfgren H. Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial. BMC Musculoskelet Disord 2014; 15: 34.
14. Pereira SN, Hitzl W, Bullmann V, Meier O, Koller H. Sagittal balance of the cervical spine: an analysis of occipitocervical and spinopelvic interdependence, with C-7 slope as a marker of cervical and spinopelvic alignment. J Neurosurg Spine 2015; 23: 16-23.
15. Scheer JK, Tang JA, Smith JS, Acosta FL, Prosoptalhis TS, Blondel B, Bess S, Shaffrey CI, Deviren V, Lafage V, Schwabb F, Ames CP, and The International Spine Study Group. Cervical spine alignment, sagittal deformity, and clinical implications. J Neurosurg Spine 2013; 19: 141-159.
16. Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T. Agerelated changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects. Eur Spine J 2012; 21: 1492-1498