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. 2025 Mar 15;39(3):341-345.
doi: 10.7507/1002-1892.202409010.

[Correlation analysis between preoperative C 2 slope and effectiveness at 2 years after short-segment anterior cervical discectomy and fusion]

[Article in Chinese]
Zhaojun Cheng  1   2 , Yan Gong  1 , Yanchi Gan  3 , Jiahui He  4 , De Liang  1 , Hui Ren  5 , Xiaobing Jiang  5
Affiliations

[Correlation analysis between preoperative C 2 slope and effectiveness at 2 years after short-segment anterior cervical discectomy and fusion]

[Article in Chinese]
Zhaojun Cheng et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To investigate correlation between preoperative C 2 slope (C2S) and effectiveness at 2 years after short-segment anterior cervical discectomy and fusion (ACDF), with the aim of providing reliable indicators for predicting effectiveness.

Methods: One hundred and eighteen patients with cervical spondylotic myelopathy, who received short-segment ACDF between January 2018 and December 2022 and met the selection criteria, were enrolled in the study. There were 46 males and 72 females, aged from 26 to 80 years, with a mean age of 53.6 years. The operative duration was (127.6±33.46) minutes and the intraoperative blood loss was (34.75±30.40) mL. All patients were followed up 2 years. The pre- and post-operative Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score for pain were recorded. Based on the anteroposterior and lateral cervical X-ray films, the sagittal parameters of the cervical spine were measured [C 2-C 7 Cobb angle, C 0-C 2 Cobb angle, T 1 slope, C2S, sagittal segmental angle (SSA) of the surgical segment, and average surgical disc height (ASDH) of the surgical segment]. Statistical analyses were performed to assess the differences in these indicators between pre- and post-operation, as well as the correlations between the preoperative C2S and the JOA score, NDI, and VAS score at 2 years after operation. The patients were allocated into group A (C2S >11.73°) and group B (C2S≤ 11.73°) according to the median value of the preoperative C2S (11.73°). The JOA score, NDI, and VAS score before operation and at 2 years after operation, as well as the differences between pre- and post-operative values (change values), were compared between the two groups.

Results: The T 1 slope, C 2-C 7 Cobb angle, C 0-C 2 Cobb angle, SSA, and ASDH at immediate after operation and JOA score, NDI, and VAS score at 2 years after operation significantly improved in 118 patients when compared with preoperative ones ( P<0.05). Pearson correlation analysis showed that preoperative C2S was not correlated with JOA score and NDI at 2 years after operation ( P>0.05), but negatively correlated with VAS score ( P<0.05). There were 59 patients with preoperative C2S>11.73° (group A) and 59 with C2S≤11.73° (group B). There was no significant difference in preoperative JOA score, NDI, and VAS score between the two groups ( P>0.05). There were significant differences in VAS score at 2 year after operation and the change value between the two groups ( P<0.05); there was no significant difference in the JOA score and NDI ( P>0.05).

Conclusion: Patients with cervical spondylotic myelopathy and a higher preoperative C2S exhibited superior long-term pain relief and effectiveness following short-segment ACDF.

目的: 探讨短节段颈椎前路椎间盘切除融合术（anterior cervical discectomy and fusion，ACDF）术前C 2倾斜角（C 2 slope，C2S）与术后2年疗效的相关性，以期为预测手术结局提供可靠指标。.

方法: 以2018年1月—2022年12月接受短节段ACDF治疗的脊髓型颈椎病患者作为研究对象，其中118例符合选择标准纳入研究。其中，男46例，女72例；年龄26～80岁，平均53.6岁。手术时间（127.57±33.46）min，术中出血量（34.75±30.40）mL。术后均获随访2年。记录手术前后颈椎功能障碍指数（NDI）、日本骨科协会（JOA）评分、疼痛视觉模拟评分（VAS）；基于颈椎正侧位X线片，测量颈椎矢状位参数 ［C 2～C 7 Cobb角、C 0～C 2 Cobb角、T 1倾斜角、C2S、手术节段前凸角（sagittal segmental angle，SSA）、手术节段平均椎间隙高度（average surgical disc height，ASDH）］，统计分析上述指标手术前后差异以及术前C2S与术后2年JOA评分、NDI及VAS评分相关性。根据术前C2S中位数（11.73°）将患者分为A组（>11.73°）及B组（≤11.73°），对两组术前及术后2年JOA评分、NDI、VAS评分以及手术前后差值（变化值）进行比较。.

结果: 118例患者术后即刻T 1倾斜角、C 2～C 7 Cobb角、C 0～C 2 Cobb角、SSA、ASDH以及术后2年JOA评分、NDI、VAS评分均较术前改善（ P<0.05）。Pearson相关分析示，术前C2S与术后2年JOA评分、NDI无相关（ P>0.05），与术后2年VAS评分成负相关（ P<0.05）。118例患者中，59例术前C2S>11.73°（A组）、59例≤11.73°（B组）。两组患者术前JOA评分、NDI、VAS评分差异均无统计学意义（ P>0.05）。术后2年VAS评分及变化值A组均优于B组，差异有统计学意义（ P<0.05）； JOA评分、NDI组间差异均无统计学意义（ P>0.05）。.

结论: 脊髓型颈椎病患者术前C2S越大，短节段ACDF术后2年疼痛程度越轻，远期疗效更好。.

Keywords: C2 slope; anterior cervical discectomy and fusion; cervical spondylotic myelopathy; sagittal parameter.

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Conflict of interest statement

利益冲突 在课题研究和文章撰写过程中不存在利益冲突

Figures

图 1
图 1
Measurement diagram of cervical spine sagittal parameters 颈椎矢状位参数测量示意图
图 2
图 2
A 70-year-old female patient with cervical spondylotic myelopathy at C5-7 患者，女，70岁，C5～7脊髓型颈椎病
See this image and copyright information in PMC

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