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Tag: alignment|article link|clinical outcomes|correlation

Prospective Randomized Double Blinded Clinical Study Evaluating the Correlation of Clinical Outcomes and Cervical Sagittal Alignment.

By wp_zaman

Prospective Randomized Double Blinded Clinical Study Evaluating the Correlation of Clinical Outcomes and Cervical Sagittal Alignment.

Neurosurgery. 2011 Jan 26;

Authors: Villavicencio AT, Babuska JM, Ashton A, Busch E, Roeca C, Nelson EL, Mason A, Burneikiene S

BACKGROUND:: Sagittal alignment of the cervical spine has received increased attention in the literature as an important determinant of clinical outcomes following anterior cervical discectomy and fusion (ACDF). Surgeons use parallel or lordotically fashioned grafts based on preference or simple availability. OBJECTIVE:: To quantitatively assess and compare cervical sagittal alignment and clinical outcome when lordotic or parallel allografts were used for fusion. METHODS:: A prospective, randomized, double blinded clinical study that enrolled 122 patients was performed. The mean follow-up was 37.5 months (range, 12 – 54). RESULTS:: The mean postoperative cervical sagittal alignment (CSA) was 19 degrees (range, -7 to 36) and 18 degrees (range, -7 to 37) in the lordotic and parallel graft patient groups, respectively. The mean segmental sagittal alignment (SSA) was 6 degrees (range, -4 to 19) and 7 degrees (range, -3 to 19) in the lordotic and parallel graft patient groups, respectively. There were no statistically significant differences in clinical outcome scores when comparing the lordotic and parallel graft patient groups. However, patients that maintained or improved SSA, regardless of graft type, achieved a higher degree of improvement in SF-36 PCS and NDI scores. This was statistically significant (P < 0.038). CONCLUSION:: The use of lordotically-shaped allografts does not increase cervical/segmental sagittal alignment or improve clinical outcomes. Maintaining a consistent segmental sagittal alignment or increasing segmental lordosis was related to a higher degree of improvement in clinical outcomes.

PMID: 21273933 [PubMed – as supplied by publisher]