Rakesh Kumar, Landon Basner, Thomas Hanks, Aiyush Bansal, Murad Alostaz, Alice Sohn, Patricia Lipson, Jean-Christophe A Leveque, Venu M Nemani, Philip K Louie
{"title":"单节段颈椎前路椎间盘切除术融合治疗退行性病理后相邻节段角的早期命运如何？","authors":"Rakesh Kumar, Landon Basner, Thomas Hanks, Aiyush Bansal, Murad Alostaz, Alice Sohn, Patricia Lipson, Jean-Christophe A Leveque, Venu M Nemani, Philip K Louie","doi":"10.1097/BSD.0000000000001836","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series study.</p><p><strong>Objective: </strong>This study aims to investigate adjacent segmental angle changes postsingle-level anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Anterior cervical fusion's impact on adjacent levels and global cervical alignment remains insufficiently understood, with potential implications for surgical planning and radiographic outcomes.</p><p><strong>Methods: </strong>A single-center retrospective analysis of consecutive patients undergoing single-level ACDF for degenerative pathology was conducted. Preoperative and 12-month postoperative lateral cervical plain radiographs were evaluated. Measured parameters included pre and postoperative C2-C7 lordosis, segmental lordosis of the fusion and adjacent levels, T1-slope, occipito-C2 angle (O-C2), and C2-C7 sagittal vertical axis. Patients were stratified by operative level. Univariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Seventy patients were included (18 C4-C5, 35 C5-C6, and 17 C6-C7 operative levels). No significant changes were observed in any of the measured parameters at the C4-C5 level. Likewise, at the C5-C6 level, there were no clinically significant changes in any parameters. At the C6-C7 level, significant alterations in segmental angles were observed. At this level, the ACDF procedure led to an overall loss of lordosis of 3.48 degrees with an associated lordotic change in the supra- and infra-adjacent levels, which preferentially favored change at the supra-adjacent level (4.83 degrees of lordosis response) compared with the infra-adjacent level (3.52 degrees of lordotic response).</p><p><strong>Conclusions: </strong>This study suggests that preoperative cervical lordosis may influence adjacent segmental angles after single-level ACDF procedures, offering crucial insights for future research and preoperative planning. Understanding these dynamics is crucial for preserving cervical lordosis and managing adjacent segment disease.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"What is the Early Fate of the Adjacent Segmental Angles Following a Single-level Anterior Cervical Discectomy Fusion for Degenerative Pathology?\",\"authors\":\"Rakesh Kumar, Landon Basner, Thomas Hanks, Aiyush Bansal, Murad Alostaz, Alice Sohn, Patricia Lipson, Jean-Christophe A Leveque, Venu M Nemani, Philip K Louie\",\"doi\":\"10.1097/BSD.0000000000001836\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective case series study.</p><p><strong>Objective: </strong>This study aims to investigate adjacent segmental angle changes postsingle-level anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Anterior cervical fusion's impact on adjacent levels and global cervical alignment remains insufficiently understood, with potential implications for surgical planning and radiographic outcomes.</p><p><strong>Methods: </strong>A single-center retrospective analysis of consecutive patients undergoing single-level ACDF for degenerative pathology was conducted. Preoperative and 12-month postoperative lateral cervical plain radiographs were evaluated. Measured parameters included pre and postoperative C2-C7 lordosis, segmental lordosis of the fusion and adjacent levels, T1-slope, occipito-C2 angle (O-C2), and C2-C7 sagittal vertical axis. Patients were stratified by operative level. Univariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Seventy patients were included (18 C4-C5, 35 C5-C6, and 17 C6-C7 operative levels). No significant changes were observed in any of the measured parameters at the C4-C5 level. Likewise, at the C5-C6 level, there were no clinically significant changes in any parameters. At the C6-C7 level, significant alterations in segmental angles were observed. At this level, the ACDF procedure led to an overall loss of lordosis of 3.48 degrees with an associated lordotic change in the supra- and infra-adjacent levels, which preferentially favored change at the supra-adjacent level (4.83 degrees of lordosis response) compared with the infra-adjacent level (3.52 degrees of lordotic response).</p><p><strong>Conclusions: </strong>This study suggests that preoperative cervical lordosis may influence adjacent segmental angles after single-level ACDF procedures, offering crucial insights for future research and preoperative planning. Understanding these dynamics is crucial for preserving cervical lordosis and managing adjacent segment disease.</p><p><strong>Level of evidence: </strong>Level IV.</p>\",\"PeriodicalId\":10457,\"journal\":{\"name\":\"Clinical Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Spine Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BSD.0000000000001836\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Spine Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BSD.0000000000001836","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
What is the Early Fate of the Adjacent Segmental Angles Following a Single-level Anterior Cervical Discectomy Fusion for Degenerative Pathology?
Study design: Retrospective case series study.
Objective: This study aims to investigate adjacent segmental angle changes postsingle-level anterior cervical discectomy and fusion (ACDF).
Summary of background data: Anterior cervical fusion's impact on adjacent levels and global cervical alignment remains insufficiently understood, with potential implications for surgical planning and radiographic outcomes.
Methods: A single-center retrospective analysis of consecutive patients undergoing single-level ACDF for degenerative pathology was conducted. Preoperative and 12-month postoperative lateral cervical plain radiographs were evaluated. Measured parameters included pre and postoperative C2-C7 lordosis, segmental lordosis of the fusion and adjacent levels, T1-slope, occipito-C2 angle (O-C2), and C2-C7 sagittal vertical axis. Patients were stratified by operative level. Univariate and multivariate analyses were performed.
Results: Seventy patients were included (18 C4-C5, 35 C5-C6, and 17 C6-C7 operative levels). No significant changes were observed in any of the measured parameters at the C4-C5 level. Likewise, at the C5-C6 level, there were no clinically significant changes in any parameters. At the C6-C7 level, significant alterations in segmental angles were observed. At this level, the ACDF procedure led to an overall loss of lordosis of 3.48 degrees with an associated lordotic change in the supra- and infra-adjacent levels, which preferentially favored change at the supra-adjacent level (4.83 degrees of lordosis response) compared with the infra-adjacent level (3.52 degrees of lordotic response).
Conclusions: This study suggests that preoperative cervical lordosis may influence adjacent segmental angles after single-level ACDF procedures, offering crucial insights for future research and preoperative planning. Understanding these dynamics is crucial for preserving cervical lordosis and managing adjacent segment disease.
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.
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