Changing sagittal balance parameters in patients underwent one and TWO segment anterior cervical discectomy and fusion (ACDF)

In this study, included 55 patients operated (ACDF) in the department of Neurosurgery in Düzce üniversity between January 2015 and January 2017 who are between 18 and 70 years, has one and two level soft cervical disc hernia that had not responded to medical treatment for at last 3 weeks and radiological imaging related with patients symptoms. The study retrospectively designated. Preoperative cervical MRI, antero-posterior and lateral cervical roentgenography, neurological examination, visual analog scala (VAS) values, and among sagittal balance parameters, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt were evaluated. Postoperative antero-lateral roentgenography, cervical lordosis angle, cranial insidence, cranial slope, C2 tilt and VAS values 1th, 15th days, and the third months after the surgery were evaluated. Preoperative and postoperative cervical lordosis angle, C2 tilt, cranial insidence and cranial slope values measured and evaluted the correlation of these parameter changes with pain statistically. There is no statistically significant differences was found between preoperative and postoperative cranial insidence, cranial slope, cervical lordosis angle and C2 tilt values. Statistical analysis showed that change of VAS values is significant for every level and two levels disk hernia all postoperative follow-up times (p˂0.001). The main hypothesis of this study, which is surgical treatment with ACDF changes cervical sagittal balance parameters signifintly in parallel aspect weren't supported by our study but, restoration of cervical sagittal parameters for cervical lordosis angle, cranial insidence, kranial slope and C2 tilt parameters come closer values of normal population after surgery period. However these changings weren't statistically significant. In addition, the clinical results of surgical treatment of cervical disc disease generally come before radiological improvement like other areas of spinal surgery. It is thought that statistically significant results can be obtained in the follow-up long term results by observing the cervical sagittal balance parameters approaching the values of normal population in the early postoperative period. Keywords: Cervical sagittal balance, cervical disc hernia, surgical treatment, cervical lordosis angle, C2 tilt, cranial insidance, cranial slope