DOI: https://doi.org/10.22141/1608-1706.3.19.2018.136409

Optimization of surgical correction of spinal motion segment sagittal contour when performing anterior subaxial cervical fusion

E.I. Slynko, A.S. Nekhlopochin

Abstract


Background. Vertical cylindrical mesh implant and anterior rigid plate is the most common combination for performing subaxial cervical spine anterior decompression and fusion surgery. Despite the considerable clinical experience, there is currently no consensus on optimal correction of the height of the operated spinal motion segment and the formation of a certain segmental profile in the surgical intervention zone. The purpose was to improve the state of sagittal kyphosis of the operated segment in the long­term postoperative period in patients who underwent anterior subaxial cervical fusion. Materials and methods. We performed retrospective evaluation and X­ray analysis of sagittal kyphosis in 151 patients after anterior bisegmental subaxial cervical fusion due to traumatic injury. A statistical analysis was carried out, and the dependence of the final results on the degree of intraoperative correction was determined. We verified the ranges of intraoperative values of spinal motion segment sagittal contour forming various biomechanical responses of the cervical spine in the long­term postoperative period. Results. The dependence of the final state of segmental kyphosis of the operated segment was determined by the method of nonlinear regression analysis. Cluster analysis revealed the following ranges of intraoperative values of segmental kyphosis: < –6.15°; –6.15°… –3.10°; > –3.10°, which determine different dynamics of postoperative changes. Conclusions. Correction of kyphosis in the range of –6.15°… –3.10° is optimal for maintaining the physiological curvature of the operated segment in the long­term postoperative period.


Keywords


cervical fusion; vertical cylindrical mesh implant; segmental kyphosis; nonlinear regression analysis; cluster analysis

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