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Objective <p>While some studies suggest cervical disc replacement (CDR) may yield better clinical and radiographic outcomes than anterior cervical discectomy and fusion (ACDF), data on early segmental angle changes are limited. This study assessed early postoperative changes in adjacent segmental angles and overall cervical alignment after single-level anterior cervical surgeries, comparing CDR and ACDF.</p> Methods <p>In this retrospective, single-institution study of 117 patients (47 CDR, 70 ACDF; mean age 55.9 ± 13.5 years), pre- and postoperative lateral cervical radiographs were analyzed for sagittal parameters. Paired t-tests evaluated within-patient changes; Welch’s t-tests compared changes between surgical groups. Univariate and multivariate linear regressions examined associations between cervical alignment and adjacent segment angle changes.</p> Results <p>No clinically meaningful differences were observed in pre- to postoperative angles or between CDR and ACDF groups. Changes in cervical angles were generally small, yielding low effect sizes and limited power. However, across all levels, univariate analysis revealed that increases in C2-7 lordosis correlated with increases in the supra-adjacent angle (β = 0.15, <i>p</i> &lt; 0.001), while increases in T1 slope minus cervical lordosis (T1S-CL) and C2-C7 sagittal vertical axis (SVA) were associated with decreases in the supra-adjacent (β = − 0.13, <i>p</i> &lt; 0.001) and caudal adjacent angles (β = − 0.10, <i>p</i> &lt; 0.001), respectively. In the C6-7 subgroup, increased C0–C2 angle was linked to decreased caudal angle (β = − 0.22, <i>p</i> &lt; 0.001, power = 0.94).</p> Conclusions <p>This pilot study identified minimal early segmental angle changes after ACDF or CDR, with select associations between cervical alignment parameters and adjacent segment angles. These findings provide effect size estimates to guide future adequately powered research.</p>

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Is there a difference in early postoperative adjacent segment angles following anterior cervical discectomy and fusion compared to cervical disc replacement?

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Rakesh Kumar,
  • Aiyush Bansal,
  • Kento Yamanouchi,
  • Landon Basner,
  • Thomas Hanks,
  • Murad Alostaz,
  • Mir Amaan,
  • Iyan Younus,
  • Rafael Garcia de Oliveira,
  • Venu Nemani,
  • Jean-Christophe Leveque,
  • Philip Louie

摘要

Objective

While some studies suggest cervical disc replacement (CDR) may yield better clinical and radiographic outcomes than anterior cervical discectomy and fusion (ACDF), data on early segmental angle changes are limited. This study assessed early postoperative changes in adjacent segmental angles and overall cervical alignment after single-level anterior cervical surgeries, comparing CDR and ACDF.

Methods

In this retrospective, single-institution study of 117 patients (47 CDR, 70 ACDF; mean age 55.9 ± 13.5 years), pre- and postoperative lateral cervical radiographs were analyzed for sagittal parameters. Paired t-tests evaluated within-patient changes; Welch’s t-tests compared changes between surgical groups. Univariate and multivariate linear regressions examined associations between cervical alignment and adjacent segment angle changes.

Results

No clinically meaningful differences were observed in pre- to postoperative angles or between CDR and ACDF groups. Changes in cervical angles were generally small, yielding low effect sizes and limited power. However, across all levels, univariate analysis revealed that increases in C2-7 lordosis correlated with increases in the supra-adjacent angle (β = 0.15, p < 0.001), while increases in T1 slope minus cervical lordosis (T1S-CL) and C2-C7 sagittal vertical axis (SVA) were associated with decreases in the supra-adjacent (β = − 0.13, p < 0.001) and caudal adjacent angles (β = − 0.10, p < 0.001), respectively. In the C6-7 subgroup, increased C0–C2 angle was linked to decreased caudal angle (β = − 0.22, p < 0.001, power = 0.94).

Conclusions

This pilot study identified minimal early segmental angle changes after ACDF or CDR, with select associations between cervical alignment parameters and adjacent segment angles. These findings provide effect size estimates to guide future adequately powered research.