Changes in cervical sagittal balance following anterior cervical discectomy with fusion

Introduction. Change in the sagittal balance after anterior cervical discectomy with fusion (ACDF) is a phenomenon that has not yet been sufficiently studied. The aim of this study was to assess such changes. Material and methods. 28 patients who underwent ACDF for cervical spondylosis were examined. The study was divided into three stages: preoperative, early postoperative, and late postoperative. Sagittal alignments were analysed based on X-ray AP and lateral images: angles C1 -C7, C2 -C7, C1 -C2, C1 -C4, C4 -C7 and cervical sagittal vertical axis (cSVA). Results. The cervical lordosis C2 -C7 decreased by 13% in early monitoring, after which it increased by 60% in the late postoperative phase. Post hoc analysis showed that the measured values between early and late postoperative monitoring differed significantly. Cervical sagittal vertical axis (cSVA) increased by 23% in early control and then decreased by 18% in the late postoperative phase. Post hoc analysis showed that the measured values significantly differed between preoperative and early postoperative monitoring, and between early and late postoperative monitoring. Conclusions. We have shown that the long-term effect of ACDF is correction of the sagittal balance of the cervical spine. Immediately after the procedure, a disturbance in the cervical spine curvature to the morphology of the entire spine is observed.