Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion
Background: Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence ra...
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| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Craniovertebral Junction and Spine |
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| Online Access: | https://journals.lww.com/10.4103/jcvjs.jcvjs_116_24 |
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| author | Rajkishen Narayanan Nicholas B. Pohl Jonathan Dalton Yunsoo Lee Alexa Tomlak Anthony Labarbiera Meryem Guler Emilie Sawicki Sebastian I. Fras Mark F. Kurd John J. Mangan Ian David Kaye Jose A. Canseco Alan S. Hilibrand Alexander R. Vaccaro Christopher K. Kepler Gregory D. Schroeder Joseph K. Lee |
| author_facet | Rajkishen Narayanan Nicholas B. Pohl Jonathan Dalton Yunsoo Lee Alexa Tomlak Anthony Labarbiera Meryem Guler Emilie Sawicki Sebastian I. Fras Mark F. Kurd John J. Mangan Ian David Kaye Jose A. Canseco Alan S. Hilibrand Alexander R. Vaccaro Christopher K. Kepler Gregory D. Schroeder Joseph K. Lee |
| author_sort | Rajkishen Narayanan |
| collection | DOAJ |
| description | Background:
Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence rates or long-term radiographic outcomes with hyperlordotic and standard lordotic spacers. This study compares long-term radiographic outcomes, subsidence rate, and rate of fusion in patients who underwent ACDF with hyperlordotic or standard interbody placement.
Materials and Methods:
Patients who underwent 1–3-level ACDF with either a standard lordosis or hyperlordotic interbody were included. Standard radiographs were evaluated for C2–7 lordosis (CL), sagittal vertical axis, C2 slope (C2S), T1 slope (T1S), subsidence rate, and fusion.
Results:
Forty-five patients underwent ACDF with hyperlordotic interbody placement and after a 1:1 propensity match with standard lordotic patients, 90 patients were included. 1-year postoperative radiographs demonstrated the hyperlordotic cohort achieved higher CL (15.3° ± 10.6° vs. 9.58° ± 8.88°; P = 0.007). The change in CL (8.42° ± 9.42° vs. 0.94° ± 8.67°; P < 0.001), change in C2S (−4.02° ± 6.68° vs. −1.11° ± 5.42°; P = 0.026), and change in T1S (3.49° ± 7.30° vs. 0.04° ± 6.86°, P = 0.008) between pre- and postoperative imaging were larger in the hyperlordotic cohort. There was no difference in overall subsidence (P = 0.183) and rate of fusion (P = 0.353) between the cohorts.
Conclusion:
Hyperlordotic spacer placement in ACDF can provide increased CL compared to standard lordosis spacers, which can be considered for patients requiring restoration or maintenance of CL following ACDF. |
| format | Article |
| id | doaj-art-84e3824223f742b685a61cbeb4292fd2 |
| institution | Kabale University |
| issn | 0974-8237 0976-9285 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj-art-84e3824223f742b685a61cbeb4292fd22025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115447548110.4103/jcvjs.jcvjs_116_24Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusionRajkishen NarayananNicholas B. PohlJonathan DaltonYunsoo LeeAlexa TomlakAnthony LabarbieraMeryem GulerEmilie SawickiSebastian I. FrasMark F. KurdJohn J. ManganIan David KayeJose A. CansecoAlan S. HilibrandAlexander R. VaccaroChristopher K. KeplerGregory D. SchroederJoseph K. LeeBackground: Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence rates or long-term radiographic outcomes with hyperlordotic and standard lordotic spacers. This study compares long-term radiographic outcomes, subsidence rate, and rate of fusion in patients who underwent ACDF with hyperlordotic or standard interbody placement. Materials and Methods: Patients who underwent 1–3-level ACDF with either a standard lordosis or hyperlordotic interbody were included. Standard radiographs were evaluated for C2–7 lordosis (CL), sagittal vertical axis, C2 slope (C2S), T1 slope (T1S), subsidence rate, and fusion. Results: Forty-five patients underwent ACDF with hyperlordotic interbody placement and after a 1:1 propensity match with standard lordotic patients, 90 patients were included. 1-year postoperative radiographs demonstrated the hyperlordotic cohort achieved higher CL (15.3° ± 10.6° vs. 9.58° ± 8.88°; P = 0.007). The change in CL (8.42° ± 9.42° vs. 0.94° ± 8.67°; P < 0.001), change in C2S (−4.02° ± 6.68° vs. −1.11° ± 5.42°; P = 0.026), and change in T1S (3.49° ± 7.30° vs. 0.04° ± 6.86°, P = 0.008) between pre- and postoperative imaging were larger in the hyperlordotic cohort. There was no difference in overall subsidence (P = 0.183) and rate of fusion (P = 0.353) between the cohorts. Conclusion: Hyperlordotic spacer placement in ACDF can provide increased CL compared to standard lordosis spacers, which can be considered for patients requiring restoration or maintenance of CL following ACDF.https://journals.lww.com/10.4103/jcvjs.jcvjs_116_24anterior cervical discectomy and fusioncervical lordosiscervical spinehyperlordotic interbodysubsidence |
| spellingShingle | Rajkishen Narayanan Nicholas B. Pohl Jonathan Dalton Yunsoo Lee Alexa Tomlak Anthony Labarbiera Meryem Guler Emilie Sawicki Sebastian I. Fras Mark F. Kurd John J. Mangan Ian David Kaye Jose A. Canseco Alan S. Hilibrand Alexander R. Vaccaro Christopher K. Kepler Gregory D. Schroeder Joseph K. Lee Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion Journal of Craniovertebral Junction and Spine anterior cervical discectomy and fusion cervical lordosis cervical spine hyperlordotic interbody subsidence |
| title | Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| title_full | Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| title_fullStr | Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| title_full_unstemmed | Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| title_short | Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| title_sort | radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion |
| topic | anterior cervical discectomy and fusion cervical lordosis cervical spine hyperlordotic interbody subsidence |
| url | https://journals.lww.com/10.4103/jcvjs.jcvjs_116_24 |
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