How do C2 tilt and C2 slope correlate with patient reported outcomes in patients after anterior cervical discectomy and fusion? |
| |
| Authors: | Srikanth N Divi Wesley H Bronson Jose A Canseco Michael Chang Dhruv KC Goyal Kristen J Nicholson Victor E Mujica Ian David Kaye Mark F Kurd Barrett I Woods Kristen E Radcliff Jeffrey A Rihn David Greg Anderson Alan S Hilibrand Christopher K Kepler Alexander R Vaccaro Gregory D Schroeder |
| |
| Institution: | 1. Hospital for Special Surgery, Department of Orthopedic Surgery, New York, NY, USA;2. Orthopedic Soft Tissue Research Program, Hospital for Special Surgery, 535 East 70th St., New York, NY, USA;3. Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA;1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA;2. Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, the Netherlands, 3584 CX;3. Department of Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, the Netherlands, 3584 CX;4. Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA;1. Spine Unit, Av Reyes Catolicos 2, 28040 Madrid, Spain;2. Department of Anesthesiology, Av Reyes Catolicos 2, 28040 Madrid, Spain;3. Pulmonary Department, Av Reyes Catolicos 2, 28040 Madrid, Spain;4. Department of Statistics Fundación Jiménez Diaz, Av Reyes Catolicos 2, 28040 Madrid, Spain;5. Hospital General de Villalba, Orthopedic Department, Collado Villalba, 28400 Madrid, Spain;1. Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea;2. Spine Center, Department of Orthopedics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong-ro, 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea;1. Second Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Rd, Shanghai, China, 200001;2. Department of Spine Surgery, Changhai Hospital, Second Military Medical University, 168 Changhai Rd, Shanghai, China, 200433;3. Department of Spine Surgery, Shanghai First People''s Hospital, Shanghai Jiao Tong University, 85 Wujin Rd, Shanghai, China, 200080;4. Department of Orthopedics, Linzhou Hospital of Traditional Chinese Medicine, 244 Taihang Rd, Linzhou, China, 456550;5. Department of Orthopedics, Fifth Hospital of Southern Medical University, Southern Medical University, 566 Congcheng Ave, Guangzhou, China, 510900;6. Department of Spine Surgery, Shenzhen Hospital of Beijing University, 1120 Lianhua Rd, Shenzhen, China, 518036;7. Department of Spine Surgery, General Hospital of Nanjing Military Command, 305 East Zhongshan Rd, Nanjing, China, 210000;1. Brigham and Women''s Hospital, Department of Radiology, Boston, MA, USA;2. Massachusetts General Hospital, Department of Orthopedic Surgery, Boston, MA, USA |
| |
| Abstract: | BACKGROUND/CONTEXTC2 tilt and C2 slope are quick and easy measurements to obtain on lateral radiographs and may be used to determine overall cervical sagittal alignment; however, the influence of these measurements on patient outcomes has not been well established in literature.PURPOSETo determine if C2 tilt and/or C2 slope predict patient outcomes better compared with conventional radiographic measures after an anterior cervical discectomy and fusion (ACDF).STUDY DESIGN/SETTINGRetrospective cohort study.PATIENT SAMPLEA total of 249 patients who underwent 1 to 3 level ACDF to address radiculopathy and/or myelopathy at a single academic institution between 2011 and 2015 were identified. Patients with less than 1 year of follow-up were excluded.OUTCOME MEASURESPatient Reported Outcomes: Neck Disability Index (NDI), Physical Component Score-12 (PCS-12), and Mental Component Score (MCS-12), Visual Analog Score (VAS) Neck and Arm scoresCervical radiographic measurements: C2 tilt, C2 slope, C2–C7 lordosis, cervical SVA, T1 slope, T1 slope minus cervical lordosis (TS-CL), and C2–C7 ROMMETHODSPearson correlation tests were performed to assess for significant associations between radiographic measurements and patient outcomes. Multiple linear regression models were developed adjusting for demographics and radiographic parameters to determine which factors were predictive of patient outcomes.RESULTSC2 tilt and TS-CL correlated with all postoperative physical outcome scores (NDI, PCS-12, VAS Neck and ARM; p<.05), however no association was seen between C2 slope and postoperative outcomes. After accounting for the presence of subaxial deformity, C2 tilt and TS-CL remained strongly correlated to patient outcome scores. With multiple linear regression, C2 tilt was a significant predictor for NDI, whereas TS-CL was a significant predictor for PCS-12, VAS Neck and VAS Arm.CONCLUSIONSC2 tilt significantly correlated with well-described conventional cervical parameters as well as postoperative physical outcomes measures, especially NDI, on multivariate analysis. C2 tilt may provide an easy and practical tool for predicting physical outcomes after ACDF. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
