Radiographic Analysis Comparison of Cervical Alignment After Variable Level of Anterior Cervical Discectomy and Fusion (ACDF)

Background: To compare the radiographic cervical lordosis alignment between pre-operative and post-operative surgery after variable level of anterior cervical discectomy and fusion (ACDF) .In the current review, the standard surgical treatment of cervical spondylotic myelopathy is ACDF the restoration and maintenance of cervical lordosis alignment is an important clinical parameter after single level or multilevel anterior cervical discectomy and fusion. The increase or decrease cervical lordosis alignment is affected by the sagittal vertical axis and balance. Methods: This study was performed a retrospective radiographic analysis of 147 patients who underwent single to multilevel ACDF (Total N= 147; 1-level (N=36), 2-level (N=60), 3-level (N=42) and 4-level (N=9)) by orthopedic spine surgeons and neurosurgeons between 2016 and 2018. The authors measured the cervical lordosis alignment of the cervical spine using the Cobb method (Inferior endplate of C2 to inferior endplate of C7) at pre-operative and post-operative surgery. Radiographs were measured by three orthopedic doctor viewers. Statistical analysis were performed using R software. Results: The radiographic analysis comparison of cervical alignment after ACDF was showed the results that cervical lordosis alignment had no significantly change of decreased cervical lordosis alignment at pre-op mean 14.88°(± 8.66) and initial post-op mean 13.01°(±7.65) in all level of ACDF. Conclusions: The radiographic analysis of variable level anterior cervical discectomy and fusion in single to multilevel (1-level, 2-level, 3-level and 4-level) has no significantly change in cervical lordosis alignment after initial postop surgery.