Restitution of Cervical Lordosis Following Anterior Cervical Discectomy and Fusion Using a Fixed Lordotic Angle Cage

TL;DR

This study shows that using a wedge-shaped implant in cervical spine surgery helps restore natural neck curvature in most patients.

Contribution

A fixed lordotic angle cage consistently restores cervical lordosis after ACDF surgery.

Findings

Cobb angle values increased in 75% of patients post-surgery.

Half of the patients showed increased PTA values after surgery.

Significant differences in Cobb and PTA angles were observed pre- and post-operatively.

Abstract

Objectives: Degenerative spine disease can result in loss of cervical lordosis. It may lead to spine misalignment, which can be evaluated using quantitative measurements of the Cobb and Harrison back (posterior tangent angle, PTA) angles. Our objective was to investigate the relationship between cervical curvature and the application of wedge-shaped allografts with a predetermined inclination angle in anterior cervical discectomy and fusion (ACDF) surgery in patients with cervical degenerative disease. Additionally, we aimed to evaluate the advantages of this technique in restoring cervical lordosis.

Materials and methods: During a two-year study at a single institution, we performed one-level ACDF on 60 patients using a wedge-shaped fixed-angle allograft with a preplanned inclination angle of 7°. We analyzed changes in the preoperative and postoperative Cobb and PTA angles with standard statistics.

Results: Cobb angle values of the entire cervical segment were increased in 75% of patients after the surgery. Half of the patients had PTA values increased after surgery. There was a significant difference in the mean Cobb and PTA values before and after surgery.

Conclusion: Considering the findings of this study, an ACDF using a fixed lordotic angle wedge-shaped carbon allograft consistently restores the physiological alignment of the cervical spine and reestablishes cervical lordosis.

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