#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Sagittal profile of cervical and whole spine before and after surgery of subaxial cervical spine


Authors: M. Bolcha 1,2;  P. Vachata 1,2;  M. Sameš 1
Authors place of work: Neurochirurgická klinika Fakulty zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem a Krajské zdravotní, a. s., Masarykovy nemocnice v Ústí nad Labem o. z. 1;  Lékařská fakulta univerzity Karlovy v Plzni 2
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 2, s. 57-66.
Category: Review

Summary

Introduction: Until recently, there was a lack of information on sagittal axis parameters of the cervical spine, its relationship to the global sagittal axis of the spine, and their possible implications for long-term clinical outcomes in patients following subaxial cervical spine surgery. The aim of the authors is to provide an overview of the issue from available literature.

Methods: The authors present a complete overview of local radiological parameters of the sagittal axis of the cervical spine, an overview of radiological parameters of the total sagittal axis of the spine, and also spinopelvic parameters. Normative values ​​of the majority of individual parameters are summarized. The authors discuss several topics such as: The possible effects of sagittal axis parameters on the clinical condition of an individual before surgery; furthermore, whether a change in sagittal parameters of the cervical and whole spine after subaxial cervical spine surgery can affect the clinical condition and postoperative patient satisfaction. Finally, the methodology of specific operations is discussed, including their ability to change the parameters of the sagittal axis of the spine.

Conclusion: Short patient monitoring times and the predominant use of retrospective methodology are common drawbacks of most studies. Also, there are no clearly determined procedures and specifications for surgical correction of the sagittal axis of the cervical spine. As it turns out, multi-stage procedures are more appropriate to achieve changes of the cervical sagittal axis. It is also gradually becoming apparent that any local change of the cervical spine may affect the sagittal axis of the entire spine.

Keywords:

sagittal axis of the spine – radiological parameters – cervical kyphosis – anterior cervical discectomy with fusion – adjacent segment disease


Zdroje
  1. Scheer JK, Tang JA, Smith JS, et al. International Spine Study Group. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine 2013;19(2):141−159. doi: 10.3171/2013.4.SPINE12838.
  2. Harroud A, Labelle H, Joncas J, et al. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J. 2013;22(4):849−856. doi: 10.1007/s00586-012-2591-6.
  3. Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech. 2005;18(1):40−47.
  4. Roussouly P, Gollogly S, Berthonnaud E, et al. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 2005;30(3):346−353.
  5. Schwab F, Patel A, Ungar B, et al. Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976) 2010;35(25):2224−2231. doi:10.1097/BRS.0b013e3181ee6bd4.
  6. Smith JS, Shaffrey CI, Lafage V, et al. International Spine Study Group. Spontaneous improvement of cervical alignment after correction of global sagittal balance following pedicle subtraction osteotomy. J Neurosurg Spine 2012;17(4):300−307. doi: 10.3171/2012.6.SPINE1250.
  7. Knott PT, Mardjetko SM, Techy F. The use of the T1 sagittal angle in predicting overall sagittal balance of the spine. Spine J. 2010;10(11):994−998.doi: 10.1016/j.spinee.2010.08.031.
  8. Ames CP, Blondel B, Scheer JK, et al. Cervical radiographical alignment: comprehensive assessment techniques and potential importance in cervical myelopathy. Spine (Phila Pa 1976) 2013;38(22 Suppl 1):S149−160. doi: 10.1097/BRS.0b013e3182a7f449.
  9. Toyama Y, Matsumoto M, Chiba K, et al. Realignment of postoperative cervical kyphosis in children by vertebral remodeling. Spine (Phila Pa 1976) 1994;19(22):2565−2570.
  10. Donk RD, Fehlings MG, Verhagen WIM, et al. An assessment of the most reliable method to estimate the sagittal alignment of the cervical spine: analysis of a prospective cohort of 138 cases. J Neurosurg Spine 2017;26(5):572−576. doi: 10.3171/2016.10.
  11. Lee SH, Kim KT, Seo EM, et al. The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech. 2012;25(2):E41−47. doi: 10.1097/BSD.0b013e3182396301.
  12. Kim JH, Park JY, Yi S, et al. Anterior cervical discectomy and fusion alters whole-spine sagittal alignment. Yonsei Med J. 2015;56(4):1060−1070. doi: 10.3349/ymj.2015.56.4.1060.
  13. Tan LA, Riew KD, Traynelis VC. Cervical spine deformity-Part 1: biomechanics, radiographic parameters, and classification. Neurosurgery 2017;81(2):197−203. doi: 10.1093/neuros/nyx249.
  14. Xing R, Liu W, Li X, et al. Characteristics of cervical sagittal parameters in healthy cervical spine adults and patients with cervical disc degeneration. BMC Musculoskelet Disord. 2018;19(1):37. doi:10.1186/s12891-018-1951-8.
  15. Yukawa Y, Kato F, Suda K, et al. Normative data for parameters of sagittal spinal alignment in healthy subjects: an analysis of gender specific differences and changes with aging in 626 asymptomatic individuals. Eur Spine J. 2018;27(2):426−432. doi: 10.1007/s00586-016-4807-7.
  16. Iyer S, Nemani VM, Nguyen J, et al. Impact of cervical sagittal alignment parameters on neck disability. Spine (PhilaPa 1976) 2016;41(5):371−377. doi:10.1097/BRS.0000000000001221.
  17. Yokoyama K, Kawanishi M, Yamada M, et al. Age-related variations in global spinal alignment and sagittal balance in asymptomatic Japanese adults. Neurol Res. 2017;39(5):414−418. doi:10.1080/01616412.2017.1296654.
  18. Jun HS, Chang IB, Song JH, et al. Is it possible to evaluate the parameters of cervical sagittal alignment on cervical computed tomographic scans? Spine (Phila Pa 1976) 2014;39(10):E630−636. doi:10.1097/BRS.0000000000000281.
  19. Hardacker JW, Shuford RF, Capicotto PN, et al. Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms. Spine (Phila Pa 1976) 1997;22(13):1472−1480.
  20. Tang JA, Scheer JK, Smith JS, et al. ISSG. The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery. Neurosurgery 2012;71(3):662−669.
  21. Lee SH, Son ES, Seo EM, et al. Factors determining cervical spine sagittal balance in asymptomatic adults: correlation with spinopelvic balance and thoracic inlet alignment. Spine J. 2015;15(4):705−12. doi:10.1016/j.spinee.2013.06.059.
  22. Yuan W, Zhu Y, Zhu H, et al. Preoperative cervical sagittal alignment parameters and their impacts on myelopathy in patients with cervical spondylotic myelopathy: a retrospective study. Peer J. 2017;5:e4027. doi:10.7717/peerj.4027.
  23. Kawakami M, Tamaki T, Yoshida M, et al. Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord. 1999;12(1):50−56.
  24. Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81(4):519−528. doi: 10.2106/00004623-199904000-00009.
  25. Riew KD, Norvell DC, Chapman JR, et al. Introduction/Summary statement: adjacent segment pathology. Spine (Phila Pa 1976) 2012;37(22Suppl):S1−7. doi: 10.1097/BRS.0b013e31826cef01.
  26. Park MS, Kelly MP, Lee DH, et al. Sagittal alignment as a predictor of clinical adjacent segment pathology requiring surgery after anterior cervical arthrodesis. Spine J2014;14(7):1228−1234. doi:10.1016/j.spinee.2013.09.043.
  27. Katsuura A, Hukuda S, Saruhashi Y, et al. Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J. 2001;10(4):320−324. doi: 10.1007/s005860000243.
  28. Kulkarni V, Rajshekhar V, Raghuram L. Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy: magnetic resonance imaging study evidence. J Neurosurg. 2004;100(1 Suppl Spine). doi: 10.3171/spi.2004.100.1.0002.
  29. Faldini C, Pagkrati S, Leonetti D, et al. Sagittal segmental alignment as predictor of adjacent-level degeneration after a Cloward procedure. Clin Orthop Relat Res. 2011;469(3):674−681. doi: 10.1007/s11999-010-1614-z.
  30. Villavicencio AT, Babuska JM, Ashton A, et al. Prospective, randomized, double-blind clinical study evaluating the correlation of clinical outcomes and cervical sagittal alignment. Neurosurgery 2011;68(5):1309−1316; discussion 1316. doi:10.1227/NEU.0b013e31820b51f3.
  31. Hu X, Ohnmeiss DD, Zigler JE, et al. Restoration of cervical alignment is associated with improved clinical outcome after one and two level anterior cervical discectomy and fusion. Int J Spine Surg. 2015;9:61. doi:10.14444/2061.
  32. Gillis CC, Kaszuba MC, Traynelis VC. Cervical radiographic parameters in 1-and 2-level anterior cervical discectomy and fusion. J Neurosurg Spine 2016;25(4):421−429. doi: 10.3171/2016.2.SPINE151056.
  33. Basques BA, Louie PK, Mormol J, et al. Multi- versus single-level anterior cervical discectomy and fusion: comparing sagittal alignment, early adjacent segment degeneration, and clinical outcomes. Eur Spine J. 2018;27(11):2745−2753. doi:10.1007/s00586-018-5677-y.
  34. De la Garza-Ramos R, Xu R, Ramhmdani S, et al. Long-term clinical outcomes following 3- and 4-level anterior cervical discectomy and fusion. J Neurosurg Spine 2016;24(6):885−891.doi: 10.3171/2015.10.SPINE15795.
  35. Huang DN, Yu M, Xu NF, et al. The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under Roussouly classification: a four-year follow-up study. BMC Musculoskelet Disord. 2017;18(1):87. doi: 10.1186/s12891-017-1447-y.
  36. Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull John Hopkins Hosp. 1955;96:223–224.
  37. Clovard RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958;15(6):602−617. doi: 10.3171/jns.1958.15.6.0602.
  38. Donk RD, Arnts H, Verhagen WIM, et al. Cervical sagittal alignment after different anterior discectomy procedures for single-level cervical degenerative disc disease: randomized controlled trial. Acta Neurochir. (Wien) 2017;159(12):2359−2365. doi:10.1007/s00701-017-3312-z.
  39. Barsa P, Elgawhary S, Hradil J, et al.The angular profile of a cage has no influence on segmental alignment after anterior cervical stand-alone interbody fusion. Acta Chir Orthop Traumatol Cech. 2014;81(4):281−287.
  40. Koller H, Ames C, Mehdian H, et al. Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project. Eur Spine J. 2019;28(2):32−34. doi:10.1007/s00586-018-5835-2.
Štítky
Surgery Orthopaedics Trauma surgery
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#