| Objective: First: To explore the correlation between cervical sagittal parameters and functions before the surgery of ACDF(anterior cervical discectomy and fusion)and the correlation between the changed value before and after surgery in patients with reversible cervical kyphosis(CK);Second,To investigate the difference of cervical sagittal parameters and functions before surgery and the difference of the changed value before and after surgery in patients with cervical spondylopathy with reversible cervical kyphosis with different number of responsible segments,as well as the effect of surgery on cervical spine sagittal parameters and functions.Third,to explore the feasibility of neck tilt /T1 slope(NT/T1S)in evaluating cervical spondylopathy with reversible cervical kyphosis.Methods: A retrospective study was performed on 40 patients with cervical spondylopathy with reversible cervical kyphosis who underwent ACDF surgery from January 2016 to January 2021 and were followed up for at least 1 year after surgery.Data of hospitalized patients and follow-up patients were collected.VAS and NDI were used to evaluate cervical spine function before surgery and at the last follow-up.Data of cervical spine sagittal parameters before surgery and at the last follow-up were measured by Image J 1.6 software: Occipitocervical Angle(C0 ～ C2 Angle),lower cervical lordosis Angle(C2～C7 Angle),cervical lordosis Angle(C0～C7 Angle),responsible segment Angle,T1slope(T1S),neck tilt(NT),thoracic incident Angle(TIA),cervical tilt(CERT),crainal tilt(CRAT),cervical global aliginment(CGA).△ C0-C2 Angle,△ C2-C7 Angle,△ C0-C7 Angle,△ Responsibility segment Angle,△T1S,△NT,△TIA,△CERT,△CRAT,△CGA,△VAS and △NDI indicated the change values between the preoperative and the last follow-up.All data were input into Excel software to establish a database,and statistical software SPSS24.0 was used for statistical analysis of the data,Pearson correlation analysis was used to evaluate the correlation of all indicators before and after surgery,The measurement data were expressed by mean±standard deviation,the difference between preoperative and postoperative data was analyzed by paired sample t test,and the difference between data with different number of segments was analyzed by one-way Anova Analysis.Results: 1.The correlation between cervical sagittal parameters and functions before the surgery of ACDF and the correlation between the changed value before and after surgery in patients with cervical spondylopathy with reversible cervical kyphosis.1.1 The correlation between cervical sagittal parameters and functions before surgery.Strong correlation: C0～C2 angle and C0～C7 angle,T1 s and CERT,NDI and VAS,C2～C7 angle and NDI;Moderate correlation: C0～C2 Angle and C2～C7 Angle,C2～C7Angle and T1 S,responsible segment Angle and VAS,CGA and VAS,NT and TIA and CERT,responsible segment Angle and CGA,T1 S and TIA;Weak correlation: C0-C2 Angle and responsibility segment Angle,C2～C7 Angle and NTand CERT,T1 S and VAS,TIA and CRAT and CGA,CRAT and VAS.1.2 The correlation between the changed value before and after surgery.Strong correlation: △C0～C2 angle and △C0～C7 angle;moderately strong correlation:△C2～C7 angle and △C0～C7,△NT,△NDI,△CGA and responsible segment angle,△T1S and △TIA,△CRET and △CRAT,△NT and △TIA,responsible segment angle and △CGA,△NDI and △VAS;weak correlations: △T1S and △NT,△TIA and △CRAT,△CRAT and △CGA and △NDI.2.The difference of cervical sagittal parameters and functions before the surgery of ACDF and the difference of the changed value before and after surgery in patients with cervical spondylopathy with reversible cervical kyphosis with different number of responsible segments.There were no statistically significant differences in cervical sagittal parameters and functions before the surgery of ACDF in cervical spondylopathy with reversible cervical kyphosis patients with different number of responsible segments,nor were there statistically significant differences in the changed values before and after surgery.3.Effects of the surgery of ACDF on cervical sagittal parameters and functions in patients with cervical spondylopathy with reversible cervical kyphosis.3.1 The number of responsible segments is not distinguished: the surgery of ACDF can improve C2～C7 angle,C0～C7 angle,T1 S,responsible segment angle,CRET,CGA,NDI and VAS in patients with cervical spondylopathy with reversible cervical kyphosis;3.2 Distinguish the number of responsible segments: ACDF surgery had improvement effects on C2～C7 Angle,responsible segment Angle,CGA,NDI and VAS in patients with CK with different numbers of responsible segments.In addition,it can improve the C0～C7 Angle in patients with single and double segments,and T1 S in patients with double and triple segments.4.Feasibility of NT/T1 S in evaluating cervical spondylopathy with reversible cervical kyphosis.4.1 Feasibility of evaluating preoperative cervical sagittal parameters and functions by NT/T1S: On the whole,NT/T1 S is correlated with C2～C7 Angle,CERT and VAS.For single stage,it is correlated with C2～C7 Angle,CERT and NDI,There is no correlation with double and triple segments.4.2 Feasibility of NT/T1 S evaluation of the changes in cervical sagittal parameters and functional changes after surgery: NT/T1 S is correlated with global and single-segment△CERT.Conclusions: Angles such as T1 S,CGA and C2-C7 angle may play an important role in the pathogenesis and surgical efficacy of cervical spondylosis with reducible kyphosis,while the evaluation of other sagittal parameters may not be of great significance;2.There were no significant differences in the sagittal parameters and functions of the cervical spine before and after ACDF surgery in patients with cervical spondylosis with reducible kyphosis with different number of responsible segments;3.ACDF is an effective surgical method for the treatment of cervical spondylosis with reversible kyphosis;4.NT/T1 S may have little effect on the overall assessment of cervical spondylosis with reversible kyphosis. |
