BACKGROUND Some recent studies indicate correlations between cervical alignment and clinical outcome after anterior cervical discectomy and fusion (ACDF) surgery. However, there still are no established criteria for the interpretation of alignment, fusion and subsidence in relation to clinical outcome. METHODS A retrospective analysis of 208 radiographs of patients following ACDF with stand-alone PEEK cage implantation was performed. The measurements were obtained on plain radiographs in lateral and anteroposterior projections as well as flexion/extension radiographs. Cervical alignment was measured using the Gore, Laing and Cobb methods; fusion was evaluated by an assortment of radiographic hallmarks: the presence of bridging bone, the Cobb angle and the distances between the tips and bases of the spinous processes of the operated segments, respectively. For assessment of subsidence, we used the Mochida method in addition to ventral and dorsal segmental height reduction. Correlation analysis between the different radiological characteristics and clinical outcome at a minimum follow-up of 12 months was conducted. RESULTS Two hundred and eight patients were evaluated for alignment, fusion and subsidence. Cervical alignment using the Gore and Cobb methods correlated among each other, but failed to exhibit significant correlation with clinical outcome. Interpretation of fusion rates varied greatly (43.9 to 89.4%) depending on the criteria used. Pearson coefficients between radiographic presence of pseudarthrosis and the measurements of the spinous process distances (0.595; p < 0.001), the Cobb angles (0.187; p = 0.007) and the presence of bridging bone (0.224; p < 0.001) each exhibited statistical significance. None of the methods employed significantly correlated with clinical outcome. Regarding subsidence, we found rates of 62%, 48% and 27% using the Mochida, ventral and dorsal segmental height reduction assessment methods, respectively. Pearson correlations between pairs of Mochida/ventral (r = 0.39; p = 0.66) and Mochida/dorsal (r = 0.007; p = 0.921) height reduction assessment methods were weak and no significant correlation between subsidence rates and clinical outcome was shown. CONCLUSION All measured parameters varied depending in the measurement method used. This was most pronounced for fusion. There was a moderate positive correlation between neck pain and subsidence as measured by the Mochida method.

中文翻译：

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ACDF手术后颈椎排列，融合和下陷的影像学测量及其对临床结果的影响。

背景技术最近的一些研究表明，在颈椎前路椎间盘切除术和融合术（ACDF）手术后，宫颈对齐与临床结果之间存在相关性。但是，关于临床结果的对准，融合和沉陷的解释尚无确定的标准。方法回顾性分析ACDF并独立PEEK笼植入的208例患者的X光片。在侧面和前后投影的普通X射线照片以及屈曲/伸展X射线照片上获得测量值。使用Gore，Laing和Cobb方法测量颈椎对正；通过各种影像学标志评估融合性：桥骨的存在，Cobb角以及手术节段棘突的尖端和底部之间的距离，分别。为了评估沉降，除了腹侧和背侧节段身高降低外，我们还使用了Mochida方法。在至少12个月的随访中，进行了不同放射学特征与临床结果之间的相关性分析。结果对208例患者的对准，融合和下沉进行了评估。使用Gore和Cobb方法进行的宫颈对齐彼此相关，但是与临床结果之间没有显着相关性。根据所使用的标准，融合率的解释差异很大（43.9％至89.4％）。假关节的影像学表现与棘突距离的测量值（0.595; p <0.001），柯布角（0.187; p = 0.007）和桥接骨的存在（0.224; p <0）之间的皮尔森系数。001）均具有统计学意义。所采用的方法均未与临床结果显着相关。关于下沉，我们使用Mochida，腹侧和背侧节段性身高降低评估方法分别得出62％，48％和27％的比率。一对Mochida /腹侧（r = 0.39; p = 0.66）和Mochida /背面（r = 0.007; p = 0.921）身高降低评估方法之间的Pearson相关性较弱，并且沉降率与临床结果之间没有显着相关性。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。所采用的方法均未与临床结果显着相关。关于下沉，我们使用Mochida，腹侧和背侧节段性身高降低评估方法分别得出62％，48％和27％的比率。一对Mochida /腹侧（r = 0.39; p = 0.66）和Mochida /背面（r = 0.007; p = 0.921）身高降低评估方法之间的Pearson相关性较弱，并且沉降率与临床结果之间没有显着相关性。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。所采用的方法均未与临床结果显着相关。关于下沉，我们使用Mochida，腹侧和背侧节段性身高降低评估方法分别得出62％，48％和27％的比率。一对Mochida /腹侧（r = 0.39; p = 0.66）和Mochida /背面（r = 0.007; p = 0.921）身高降低评估方法之间的Pearson相关性较弱，并且沉降率与临床结果之间没有显着相关性。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。腹侧和背侧节段高度降低评估方法。一对Mochida /腹侧（r = 0.39; p = 0.66）和Mochida /背面（r = 0.007; p = 0.921）身高降低评估方法之间的Pearson相关性较弱，并且沉降率与临床结果之间没有显着相关性。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。腹节段和背段节段高度降低评估方法。一对Mochida /腹侧（r = 0.39; p = 0.66）和Mochida /背面（r = 0.007; p = 0.921）身高降低评估方法之间的Pearson相关性较弱，并且沉降率与临床结果之间没有显着相关性。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。结论所有测量参数根据所使用的测量方法而变化。这对于融合最为明显。用Mochida方法测得，颈部疼痛和下陷之间存在中等程度的正相关。