Die Bedeutung des sagittalen Profils bei der zervikalen Endoprothetik

Radiological and clinical results of patients after ACDF with and without preoperative software-assisted cage selection

OBJECTIVE

Comparison of software facilitated preoperatively-selected cages versus standard intraoperatively-selected cages, assessing radiological and clinical outcomes of patients after single level cervical discectomy and fusion (ACDF).

METHODS

Cages of study group patients were preoperatively chosen via software-aided dimensioning. Controls obtained cages determined by intraoperative trail implants. Primary endpoints were segmental height (SH), regional angulation (RA) and global cervical angulation (GCA) measured on plain radiographs before, immediately and 12 months after surgery. Neck pain on the visual analogue scale, the neck disability index, and patient satisfaction index recorded at 12 months follow up (FU) were the secondary endpoints.

RESULTS

Each group comprised of 20 patients and both depicted similar demographics and operated segmental levels. Mean postoperative SH was significantly increased in both study and control groups, p<0.001* and p=0.006* respectively. Immediate postoperative gain of lordosis was only significant for the study group p<0.001*. At 12 months FU, SH and RA decreased significantly in both groups. GCA and all secondary endpoints were similar for various measured time points. The two groups did not show any significant difference for all investigated parameters.

CONCLUSION

The radiographical and clinical outcomes of patients receiving cages preoperatively selected by software-assistance are similar to that of patients obtaining conventionally chosen cages. However the former allows for better regional gain/restoration of lordosis.