• Neurosurgery · Nov 2020

    The Effect of T1-Slope in Spinal Parameters After Cervical Disc Arthroplasty.

    • Yi-Hsuan Kuo, Chao-Hung Kuo, Hsuan-Kan Chang, Li-Yu Fay, Tsung-Hsi Tu, Chih-Chang Chang, Henrich Cheng, Ching-Lan Wu, Jiing-Feng Lirng, Jau-Ching Wu, and Wen-Cheng Huang.
    • Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
    • Neurosurgery. 2020 Nov 16; 87 (6): 1231-1239.

    BackgroundAlthough patients with cervical kyphosis are not ideal candidates for cervical disc arthroplasty (CDA), there is a paucity of data on patients with a straight or slightly lordotic neck.ObjectiveTo correlate cervical lordosis, T1-slope, and clinical outcomes of CDA.MethodsThe study retrospectively analyzed 95 patients who underwent 1-level CDA and had 2-yr follow-up. They were divided into a high T1-slope (≥28°) group (HTSG, n = 45) and a low T1-slope (<28°) group (LTSG, n = 50). Cervical spinal alignment parameters, including T1-slope, cervical lordosis (C2-7 Cobb angle), and segmental mobility (range of motion [ROM]) at the indexed level, were compared. The clinical outcomes were also assessed.ResultsThe mean T1-slope was 28.1 ± 7.0°. After CDA, the pre- and postoperative segmental motility remained similar and cervical lordosis was preserved. All the clinical outcomes improved after CDA. The HTSG were similar to the LTSG in age, sex, segmental mobility, and clinical outcomes. However, the HTSG had higher cervical lordosis than the LTSG. Furthermore, the LTSG had increased cervical lordosis (ΔC2-7 Cobb angle), whereas the HTSG had decreased lordosis after CDA. Patients of the LTSG, who had more improvement in cervical lordosis, had a trend toward increasing segmental mobility at the index level (ΔROM) than the HTSG.ConclusionIn this series, T1-slope correlated well with global cervical lordosis but did not affect the segmental mobility. After CDA, the changes in cervical lordosis correlated with changes in segmental mobility. Therefore, segmental lordosis should be cautiously preserved during CDA as it could determine the mobility of the disc.Copyright © 2020 by the Congress of Neurological Surgeons.

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