Impact of Nonlordotic Sagittal Alignment on Short-term Outcomes of Cervical Disc Replacement
| Autor: | Jung Kee Mok, Avani S. Vaishnav, Chirag Chaudhary, R. Kiran Alluri, Ryan Lee, Hikari Urakawa, Kosuke Sato, Darren A. Chen, Catherine Himo Gang, Russel Huang, Todd J. Albert, Sheeraz A. Qureshi |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Neurospine, Vol 17, Iss 3, Pp 588-602 (2020) |
| Druh dokumentu: | article |
| ISSN: | 2586-6583 2586-6591 |
| DOI: | 10.14245/ns.2040398.199 |
| Popis: | Objective To evaluate outcomes of cervical disc replacement (CDR) in patients with nonlordotic alignment. Methods Patients who underwent CDR were retrospectively reviewed and divided into 3 cohorts: (1) neutral/lordotic segmental and C2–7 Cobb angle (L), (2) nonlordotic segmental Cobb angle, lordotic C2–7 Cobb angle (NL-S), and (3) nonlordotic segmental and C2–7 Cobb angle (NL-SC). Radiographic and patient-reported outcomes (PROMs) were compared. Results One-hundred five patients were included (L: 37, NL-S: 30, NL-SC: 38). A significant gain in segmental lordosis was seen in all cohorts at < 6 months (L: -1.90° [p = 0.007]; NL-S: -5.16° [p < 0.0001]; NL-SC: -6.00° [p < 0.0001]) and ≥ 6 months (L: -2.07° [p = 0.031; NL-S: -6.04° [p < 0.0001]; NL-SC: -6.74° [p < 0.0001]), with greater lordosis generated in preoperatively nonlordotic cohorts (p < 0.0001). C2–7 lordosis improved in the preoperatively nonlordotic cohort (NL-SC: 8.04°) at follow-up of < 6 months (-4.15°, p=0.003) and ≥ 6 months (-6.40°, p=0.003), but not enough to create lordotic alignment (< 6 months: 3.89°; ≥ 6 months: 4.06°). All cohorts showed improvement in Neck Disability Index, visual analogue scale (VAS) neck, and VAS arm, without significant difference among groups in the amount of improvement (≥ 6-month PROMs follow-up=69%). Conclusion In patients without major kyphotic deformity, CDR has the potential to generate and maintain lordosis and improve PROMs in the short-term, and can be an effective treatment option for patients with nonlordotic alignment. |
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