Document Type
Article
Publication Date
10-1-2024
Abstract
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.
Recommended Citation
Narayanan, Rajkishen; Pohl, Nicholas; Dalton, Jonathan; Lee, Yunsoo; ; Labarbiera, Anthony; Guler, Meryem; Sawicki, Emilie; Fras, Sebastian; Kurd, Mark; Mangan, John; Kaye, I David; Canseco, Jose; Hilibrand, Alan; Vaccaro, Alex; Kepler, Christopher; Schroeder, Gregory; and Lee, Joseph, "Radiographic Outcomes and Subsidence Rate in Hyperlordotic Versus Standard Lordotic Interbody Spacers in Patients Undergoing Anterior Cervical Discectomy and Fusion" (2024). Rothman Institute Faculty Papers. Paper 278.
https://jdc.jefferson.edu/rothman_institute/278
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Language
English
Included in
Health Services Administration Commons, Musculoskeletal Diseases Commons, Orthopedics Commons, Surgery Commons
Comments
This article is the author's final published version in Journal of Craniovertebral Junction and Spine, Volume 15, Issue 4, 2024, Pages 475 - 481.
The published version is available at https://doi.org/10.4103/jcvjs.jcvjs_116_24.
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