Journal List > J Korean Soc Spine Surg > v.21(1) > 1076021

J Korean Soc Spine Surg. 2014 Mar;21(1):1-7. Korean.
Published online March 31, 2014.
© Copyright 2014 Korean Society of Spine Surgery
Does Preoperative Cervical Sagittal Alignment And Range of Motion Affect Adjacent Segment Degeneration After Anterior Arthrodesis In Degenerative Cervical Spinal Disorders?: Midterm Follow up Study
Kyung-Jin Song, M.D., Kwang-Bok Lee, M.D., and Jong-Han Yim, M.D.
Department of Orthopedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Jeonju, Korea.

Corresponding author: Kwang-Bok Lee, M.D. Department of Orthopedic Surgery, Chonbuk University Hospital 634-18, Keum Am-dong, Dukjin-gu, Jeonju, Chonbuk, 561-712, Korea. TEL: 82-63-250-1760, FAX: 82-63-271-6538, Email:
Received November 16, 2011; Revised April 12, 2012; Accepted June 10, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Study Design

Retrospective study.


The purpose of this study was to investigate whether preoperative sagittal alignment and range of motion (ROM) affect adjacent segment degeneration (ASD) and disease after anterior arthrodesis in degenerative cervical spinal disorders. Summary of Literature Review:There is no study about the relationship between preoperative ROM and sagittal alignment and the development of ASD yet.

Materials and Methods

We took a retrospective approach to study 136 patients who underwent an anterior arthodesis for less than 2 segments with PEEK cage and plate construct method for degenerative cervical diseases and who have a minimum of 3 years of follow-up. We analyzed ASD and cervical ROM, such as less than 40°(group A) and more than 40°(group B) and sagittal alignment, such as lordosis or kyphosis with less than 10°(group a), 10°~30°(group b) and more than 30°(group c). Adjacent segment degeneration was graded according to Park's classification and Hillibrand method.


There was no statistically significant difference between group A(1.35±0.48) and group B (1.44±0.50) in the correlation between the cervical ROM and the variation of disc height(p=0.07). Concerning the relationship between the ROM and osteophyte formation on adjacent segment, no statistically significant difference has been found between group A(1.64±0.88) and group B(1.43±0.67) (p=0.06). The disc height change at the final follow up after cervical sagittal alignment showed no statistically significant difference among the groups: Group A presented with 1.53±0.50, group B with 1.30±0.46 and group C with 1.40±0.50.(p=0.08) Regarding sagittal alignment and osteophyte change, there was no statistically significant difference among the groups as group A showed an average of 1.33±0.48, group Ban average of 1.56±0.88 and group Can average of 1.60±0.82(p=0.07).


Although the preoperative sagittal alignment and ROM did not significantly affect adjacent segment degeneration and diseases in a mid-term follow-up evaluation after anterior arthrodesis with PEEK cage and plate in degenerative cervical spinal disorders, we think a future study is required with a sufficient number of patients and a long term follow-up because there were borderline statistical significances shown in the present study.

Keywords: Degenerative cervical disorder; Anterior cervical fusion; Sagittal alignment; Range of motion; Adjacent segment degeneration


Fig. 1
(A) neutral, (B) flexion, (C) extension. Histogram demonstrate Gore angle(C2-7) that determined from the tangent of the posterior body line of C2 and C7.
Click for larger image


Table 1
Demographic Data of Each groups
Click for larger image

Table 2
Radiographic Grading of Degenerative Changes at Adjacent Level
Click for larger image

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