Functional, Radiological and Sagittal Balance Outcomes in Surgically Treated Degenerative Cervical Disc Diseases

Abstract

Background: The treatment of degenerative spinal diseases remains focused on dealing with symptoms, using both conservative and surgical methods. Though surgery is considered an effective treatment for many cervical disorders, at times it leads to significant problems including adjacent level disease. Objectives: The aim of this study was to correlate the functional, radiographic and sagittal balance outcome in surgically treated patients for the degenerative cervical disc diseases, outline the advantages, disadvantages and the effect of the sagittal balance on the patient function and activities. Patients and Methods: This study included a total of thirty patients who had degenerative disc disease of the cervical spine at multiple levels treated by microscopic anterior cervical decompression. The average age of participants was 43.267 ± 10.780 years (26– 64). 18 patients (60%) were females and 12 patients (40%) were males. All patients were assessed and classified before and after surgery using the neck disability index and visual analogue scale. This assessment was done for both neck and arm disability. Results: The average neck disability index at the last follow-up was 17.74 ± 2.135, which was statistically significant (P < 0.05) among groups and visual analogue scale improved from 7.4 ± 0.926 to reach 3.6 ± 0.35 six months postoperatively. Full recovery was obtained between three and six months. All patients underwent a rehabilitation protocol and found no postoperative neurological deficit in this series. Conclusions: It could be concluded that cervical sagittal imbalance arising from regional and/or global spinal sagittal malalignment plays an independent role in exacerbating adjacent segment pathomechanics after multilevel fusion and should be considered during cervical fusion surgical planning. Also, it concludes that surgery significantly led to improvement of symptoms three months post operatively.