Factors Associated With Postoperative Kyphosis and Loss of Range of Motion After Cervical Disc Replacement.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-07-15 DOI:10.1097/BSD.0000000000001869

Abel De Varona-Cocero, Stephane Owusu-Sarpong, Juan Rodriguez-Rivera, Fares Ani, Camryn Myers, Constance Maglaras, Tina Raman, Themistocles Protopsaltis

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引用次数: 0

Abstract

Study design: Single-center retrospective study.

Objective: To evaluate the risks associated with postoperative kyphosis and loss of range of motion after cervical disc replacement (CDR).

Summary of background data: One of the main benefits of CDR is that it maintains physiological range of motion (ROM) and lordosis while achieving decompression. However, some patients experience loss in segmental ROM or postoperative segmental kyphosis. This study analyzes the radiographic outcomes of these patients.

Methods: Adult patients who underwent CDR were included. The cohort was divided into patients with poor x-ray outcomes (PXR) and successful x-ray outcomes (SXR). The PXR group was defined as patients who had a loss in segmental ROM (≥11 degress decrease in Δ segmental ROM) after CDR and/or postoperative segmental kyphosis at the operative level at 2-year follow-up. Sagittal alignment and other measures were compared.

Results: A total of 151 (PXR=47; SXR=104) patients met the inclusion criteria. Pre- and postoperative segmental lateral Cobb angles were more kyphotic in the PXR group (3.5 vs. -1.4 degress, P<0.001; 2.6 vs. -5.6 degress, P<0.001). There was a larger Δ in segmental lateral Cobb angle in the SXR group (-4.2 vs. -0.9 degress, P<0.001). The PXR group had more flexion and less extension (11.3 degress vs. 6.5 degress, P<0.001; -2.2 vs. -6.1 degress, P=0.049). Segmental ROM loss was significant in the PXR group (-5.7 degress vs. 1.5 degress, P<0.001). Pre- and postoperative C2-C7 lateral Cobb angles were more kyphotic in the PXR group (-1.2 vs. -9.4 degress, P<0.001; -2.9 vs. -13.9 degress, P<0.001). Pre- and postoperative cSVA were larger in the PXR group (29.6 vs. 25.3 mm, P=0.047; 30.1 vs. 22.8 mm, P=0.004). Multiple variable regressions showed higher preoperative segmental lateral Cobb angle increased odds of SXR (OR=1.217, 95% CI: 1.083-1.369, P<0.001), while larger preoperative C2-C7 ROM decreased them (OR=0.970, 95% CI: 0.994-0.996, P=0.024). No significant differences in postoperative complications were observed.

Conclusions: Patients with postoperative kyphosis or loss of ROM were more likely to have less segmental and regional C2-7 lordosis and a larger cSVA. Surgeons should consider these preoperative parameters when indicating CDR and counseling patients.

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颈椎间盘置换术后后凸和活动范围丧失的相关因素。

研究设计：单中心回顾性研究。目的：评价颈椎间盘置换术（CDR）后凸和活动范围丧失的风险。背景资料总结：CDR的主要好处之一是在实现减压的同时保持生理活动范围（ROM）和前凸。然而，一些患者会出现节段性ROM缺失或术后节段性后凸。本研究分析了这些患者的影像学结果。方法：纳入接受CDR的成年患者。该队列分为x线预后不良（PXR）和x线预后良好（SXR）的患者。PXR组定义为CDR后节段性ROM丧失（Δ节段性ROM降低≥11度）和/或术后手术水平节段性后凸的患者，随访2年。矢状对齐与其他措施比较。结果：共151例(PXR=47；SXR=104)例患者符合纳入标准。PXR组术前和术后节段性外侧Cobb角后凸更大（3.5度vs. -1.4度）。结论：术后后凸或ROM丢失的患者更有可能出现节段性和局部C2-7前凸较小，cSVA较大。外科医生在指示CDR和咨询患者时应考虑这些术前参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.