Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion

Journal of Craniovertebral Junction and Spine, 2024 · DOI: 10.4103/jcvjs.jcvjs_116_24 · Published: January 15, 2025

Simple Explanation

This study compares the outcomes of using hyperlordotic versus standard lordotic interbody spacers during ACDF surgery. ACDF is a common surgery for degenerative cervical disease. The researchers compared the two types of spacers in terms of their ability to restore cervical lordosis, the rate of subsidence (or sinking) of the spacer, and the rate of fusion (or bone healing). The study found that hyperlordotic spacers resulted in greater restoration of cervical lordosis compared to standard lordotic spacers, without increasing the risk of subsidence or affecting the rate of fusion.

Study Duration

2019 to 2022

Participants

90 patients (45 hyperlordotic, 45 standard lordotic)

Evidence Level

Not specified

Key Findings

1
Hyperlordotic spacers resulted in a significantly higher cervical lordosis (CL) at 1-year post-surgery compared to standard lordotic spacers.
2
The change in CL, C2 slope, and T1 slope were significantly larger in the hyperlordotic cohort.
3
There was no significant difference in the overall subsidence rate or fusion rate between the two groups.

Research Summary

The study compared radiographic outcomes and subsidence rates between hyperlordotic and standard lordotic interbody spacers in ACDF patients. Hyperlordotic spacers led to increased cervical lordosis and changes in other radiographic parameters compared to standard spacers, without increasing subsidence or affecting fusion rates. The findings suggest hyperlordotic spacers can be considered for patients needing restoration or maintenance of cervical lordosis after ACDF.

Practical Implications

Surgical Planning

Surgeons can use this information to select the appropriate interbody spacer based on the patient's specific needs for cervical lordosis restoration or maintenance.

Patient Outcomes

The study suggests that hyperlordotic spacers may lead to better restoration of cervical alignment, potentially improving patient outcomes related to neck pain and disability.

Future Research

Further studies could investigate the long-term clinical outcomes and patient-reported measures associated with hyperlordotic spacer placement in ACDF.

Study Limitations

1
Retrospective nature of the study with potential selection bias.
2
SVA was <4 cm in both cohorts, potentially not representing true deformity patients.
3
Differences in biomechanical materials between structural allograft and PEEK spacers could influence results.

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