Background: The cervical spine is complex and surgical management of cervical
disease remains a significant challenge. An understanding of cervical biomechanics as
well as the normative data for cervical alignment is necessary to manage complex
cervical pathology. Objective: The aim of this work is to study the impact of a Cervical
Cage on Segmental and Global Sagittal Alignment. Also to study the relation between
the clinical outcome and the degree of realignment after Cage-assisted anterior cervical
discectomy and fusion (ACDF) for single and double levels. Patients and methods: Fifty
patients were hospitalized with the diagnosis of cervical disc disease in the
neurosurgical department of Banha University and were operated upon with ACDF
using cages at one or two levels between January 2006 and January 2012. The data was
analyzed retrospectively. Results: twenty six females and twenty four males with age
ranging from 24 to 68 years (mean 38.6 St.D. 10.4) were treated with ACDF using cages
at one (37 patients) or two (13 patients) levels. We have found that ACDF at single and
double level improved the overall lordotic as well as segmental curve. Postoperative
residual chronic neck pain was strongly related to the loss of the lordotic curve and
correction of preoperative kyphosis was directly reflected on decreasing the incidence of
postoperative long term neck pain. Conclusion: Long-term follow-up of the clinical
status and the radiographic sagittal spinal alignment after 1 or 2-level Cage-assisted
ACDF reveals increased C2–7 regional as well as global lordosis. The correction or
decrease of preoperative kyphosis was directly reflected on decreasing the incidence of
postoperative long term neck pain. |
