The cervical spine is complex and surgical management of cervical disease remains a significant challenge. An understanding of cervical biomechanics as well as the normative data for cervical alignment is necessary to manage complex cervical pathology. Objective: The aim of this work is to study the impact of a Cervical Cage on Segmental and Global Sagittal Alignment. Also to study the relation between the clinical outcome and the degree of realignment after Cage-assisted anterior cervical discectomy and fusion (ACDF) for single and double levels. Patients and methods: Fifty patients were hospitalized with the diagnosis of cervical disc disease in the neurosurgical department of Banha University and were operated upon with ACDF using cages at one or two levels between January 2006 and January 2012. The data was analyzed retrospectively.Results: twenty six females and twenty four males with age ranging from 24 to 68 years (mean 38.6 St.D. 10.4) were treated with ACDF using cages at one (37 patients) or two (13 patients) levels. We have found that ACDF at single and double level improved the overall lordotic as well as segmental curve. Postoperative residual chronic neck pain was strongly related to the loss of the lordotic curve and correction of preoperative kyphosis was directly reflected on decreasing the incidence of postoperative long term neck pain.Conclusion: Long-term follow-up of the clinical status and the radiographic sagittal spinal alignment after 1 or 2-level Cage-assisted ACDF reveals increased C2–7 regional as well as global lordosis. The correction or decrease of preoperative kyphosis was directly reflected on decreasing the incidence of postoperative long term neck pain.
Keywords: Cervical spine – Cage – Sagittal Alignment