• World Neurosurg · Oct 2024

    Cervical Lordosis Correction and Segmental Height in Anterior Cervical Surgeries; The Role of Implant Choice.

    • Ahmet Serhat Eroğlu and Oğuz Kağan Demirtaş.
    • Department of Neurosurgery, Ordu Medical Park Hospital, Ordu, Turkey.
    • World Neurosurg. 2024 Oct 17.

    Objectives And BackgroundThis study aims to compare the impact of three surgical techniques-stand-alone cage placement (SAC), anterior cervical plate (ACP) fixation, and total disc replacement (TDR)-on cervical lordosis restoration and segmental height after anterior cervical discectomy at C5-6 level. To eliminate the effect of lordosis between different levels, patients operated on at the same level were included in the study. Restoring cervical lordosis is crucial for improving patient outcomes, including pain reduction and preventing mechanical complications.MethodsA retrospective screening of 89 patients who underwent single-level C5-6 surgery between 2011 and 2021 was analyzed. Patients were categorized into three groups based on the surgical technique used: SAC, ACP, or TDR. Lordotic angles and segmental heights were measured preoperatively, first-month follow-up, and at the 24-month follow-up. Statistical analysis was conducted using the Wilcoxon Signed Rank test and ANOVA, with a significance threshold set at P<.05.ResultsAll three techniques resulted in significant early and late postoperative increases in both global and segmental lordosis. The early postoperative height gain was most pronounced in the ACP group. However, no significant differences in lordosis or height preservation were observed among the groups at the 24-month follow-up. These findings align with previous studies, indicating comparable long-term outcomes across these surgical approaches.ConclusionStand-alone cage placement, anterior cervical plate fixation, and total disc replacement all effectively restore cervical lordosis and segmental height after anterior cervical discectomy at the C5-6 level. Despite early differences, the long-term results were similar, suggesting that the choice of technique should be based on individual patient needs and specific surgical considerations.Copyright © 2024. Published by Elsevier Inc.

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