The effect of preoperative sagittal alignment on the postoperative results of ACDF operation

Herniated cervical disc is displacement of the disc's nucleus through a defect in the annulus fibrosus, into the space occupied by the nerves and spinal cord. The herniated disc can then compress the nerves or cord and cause pain, numbness, tingling or weakness in the shoulders or arms. This may cause individual losses and disability by influencing activities of daily living and quality of life. Cervical malalignments are defined as increasing or decreasing of cervical lordosis, cervical kyphosis, head forward position, presence of segmental kyphosis, increase or decrease in upper cervical lordosis. We included 80 patients, which has soft cervical disc herniation in single, two or three segments into our study. Cervical lateral x-rays were taken in all patients and total as well as segmental cervical lordosis angles were evaluated and grouped by Roussouly classification method. The aim of our study was to assess the correlation between cervical malalignment and anterior cervical discectomy plus fusion (ACDF) operation's outcomes and clinical findings. Cervical lateral x-rays were taken for all patients before and after operation and evaluated cervical alignments using Toyama's classification method. Clinical findings were evaluated using patients' neurological examinations and visual analog scale (VAS). In the follow-up period; that patients' sagittal alignments got better were determined obviously and decreased VAS scores statistically significant in general. We looked at the variation between rates of recovery in comparison with cervical sagittal profile. This study showed that the operation of ACDF provides obvious clinical and radiologic recovery. Preoperative sagittal alignment is effective on results of the operation.