Study On The Influence Of Cervical Sagittal Parameters On Anterior Cervical Surgery Prognosis

Purpose:Cervical spondylotic myelopathy is one of the most common and harmful diseases in spine surgery department,with the characteristics of concealment and intermittency.Anterior cervical decompression and fusion is preferred surgical method for treatment of CSM.Methods : The study included 212 patients with CSM who underwent anterior cervical decompression and fusion.Gender,age,body mass index,surgical method,duration of symptoms,fusion segments,diabetes,smoking,drinking and cervical sagittal parameters are collected.NDI scores and JOA scores are calculated before surgery and at the last follow-up.The correlation between cervical parameters and prognosis scores is analyzed to investigate the influence of cervical sagittal parameters on surgical effect.Results:C2-7 Cobb Angle,SVA,T1 S,SCA,and T1S-CL all improved after surgery,and the last follow-up T1 S increases compared with preoperative.At the last follow-up,NDI score is positively correlated with T1S(r=0.295,p<0.001),SVA(r=0.156,p=0.023),T1S-CL(r=0.209,p=0.002),and negatively correlated with SCA(r=-0.145,p=0.035).JOA score is only negatively correlated with T1S(r=-0.193,p=0.005)and SVA(r=-0.205,p=0.003).Preoperative T1S(B=0.266,p<0.01)and age(B=0.771,p=0.041)are independent risk factors for NDI score greater than 30 at the last follow-up.The duration of symptoms(B=1.187,p=0.006)is an independent risk factor affecting JOA improvement rate less than 25%.Conclusions:After anterior cervical surgery,cervical sagittal parameters,NDI score and JOA score are significantly improved.Cervical sagittal parameter such as SVA and T1 S are closely correlated with NDI scores or JOA scores.Excessive preoperative T1 S and elderly patients are risk factors affecting postoperative NDI score deterioration,while long course of disease is a risk factor leading to low improvement rate of JOA.