How does sagittal balance relate to clinical outcomes after spine surgery for cervical spondylotic myelopathy?
The authors of a study published in Spine looked at this relationship.
Study authors examined 49 patients who underwent dorsal and ventral fusion surgery for cervical spondylotic myelopathy and performed assessments preoperatively and at three months, six months and one year postoperatively. The researchers found:
1. Regardless of the approach, most patients reported improvement in all outcomes measures, including the modified Japanese Orthopedic Association scale, Oswestry Neck Disability Index and two generalized outcomes measures.
2. The preoperative and postoperative C2 to C7 sagittal vertical axis measurements independently predicted the clinically significant improvements in SF-36 PCS scores.
3. Most patients with C2 to C7 sagittal vertical axis values greater than 40 mm didn't report overall health-related quality of life improvements. At the same time, these patients did report myelopathy improvement.
4. Postoperative sagittal balance value inversely correlated with a clinically significant improvement in SF-36 PCS scores for patients undergoing forsal surgery. However, the same was not true for ventral surgery.
5. The study authors concluded, "Preoperative and postoperative sagittal balance measurements independently predict clinical outcomes after surgery for CSM."