Comparison of 3-level anterior cervical discectomy and fusion and open-door laminoplasty in cervical sagittal balance: A retrospective study

Abstract

ObjectiveTo compare the clinical efficacy and radiological outcomes of 3-level anterior cervical discectomy and fusion (ACDF) and open-door laminoplasty (LP).MethodsA total of 74 patients from January 2017 to January 2020 were enrolled in this retrospective study. There were two groups. Group A (30 cases) received 3-level ACDF, while Group B (44 cases) received open-door LP. Clinical evaluation included perioperative parameters, Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) scores. Radiological evaluation included cervical curve depth (CCD), C2–7 angle, C2–7 sagittal vertical axis (cSVA), C7 slope (C7S), and T1 slope (T1S).ResultsPerioperative parameters such as blood loss, drainage volume after surgery, and hospital stay of patients in Group A were significantly less than those in Group B (P < .001). NDI scores decreased and JOA scores increased significantly after surgery in both groups (P < .05). There was a significant difference in both scores postoperatively and at 1 month after surgery between the two groups (P < .05). CCD and C2–7 angle of Group A increased significantly postoperatively at 1 month after surgery and at final follow-up (FFU) (P < .05). There was a significant difference in CCD and the C2–7 angle between the two groups postoperatively at 1 month after surgery and at FFU (P < .05). T1S increased significantly in Group A postoperatively and at 1 month after surgery (P < .05).Conclusion3-level ACDF and open-door LP achieved favorable clinical outcomes and ACDF benefited patients in the early stage of rehabilitation. Compared with open-door LP, 3-level ACDF had advantages of reconstructing cervical lordosis with increased CCD and C2–7 angle.