Cervicothoracic Lordosis Can Influence Outcome After Posterior Cervical Spine Surgery

颈胸椎前凸可影响后颈椎手术的疗效

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作者:Albert Vincent Berthier Brasil, Pablo Ramon Fruett da Costa, Antonio Delacy Martini Vial, Gabriel da Costa Barcellos, Eduardo Balverdu Zauk, Paulo Valdeci Worm, Marcelo Paglioli Ferreira, Nelson Pires Ferreira

Background

Previous studies on the correlation between cervical sagittal balance with improvement in quality of life showed significant

Conclusion

The parameter cervicothoracic lordosis correlates with improvement of quality life after surgery for cervical degenerative disk disease by the posterior approach.

Methods

The focused group involved patients who underwent surgical treatment of cervical degenerative disk disease by the posterior approach, due to myelopathy, radiculopathy or a combination of both. Neurologic deficit was measured before and after surgery with the Nurick Scale, postoperative quality of life, physical and mental components of SF-36 and NDI. Cervicothoracic lordosis and various sagittal balance parameters were also measured. Cervicothoracic lordosis was defined as the angle between: a) the line between the centroid of C2 and the centroid of C7; b) the line between the centroid of C7 and the centroid of T6. Correlations between postoperative quality of life and sagittal parameters were calculated.

Objective

We test whether a new parameter, cervicothoracic lordosis, can predict clinical success in this type of surgery.

Results

Twenty-nine patients between 27 and 78 years old were evaluated. Surgery types were simple decompression (laminectomy or laminoforaminotomy) (3 patients), laminoplasty (4 patients) and laminectomy with fusion in 22 patients. Significant correlations were found for C2-C7 SVA and cervicothoracic lordosis. C2-C7 SVA correlated negatively with MCS (r=-0.445, p=0.026) and PCS (r=-0.405, p=0.045). Cervicothoracic lordosis correlated positively with MCS (r=0.554, p= 0.004) and PCS (r=0.462, p=0.020) and negatively with NDI (r=-0.416, p=0.031).

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