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Updated: Feb 14, 2026

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Preoperative Alignment and Interbody Cage Design Influence Radiographic Outcomes Following Anterior Cervical

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Preoperative cervical alignment and interbody cage design significantly impact outcomes after anterior cervical discectomy and fusion (ACDF). Cage height is key for disc height, while cage placement optimizes segmental lordosis for better patient results.

Keywords:
ACDFcervical spine alignmentinterbody cagelordosissegmental correction

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Area of Science:

  • Spine Surgery
  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Anterior cervical discectomy and fusion (ACDF) is a common procedure for degenerative cervical spine conditions.
  • Understanding factors influencing postoperative alignment is crucial for optimizing ACDF outcomes.
  • The impact of baseline alignment and implant characteristics on segmental alignment requires further investigation.

Purpose of the Study:

  • To evaluate how preoperative cervical alignment and interbody cage design affect segmental alignment changes after ACDF.
  • To identify predictors of postoperative disc height and segmental lordosis following ACDF.
  • To provide insights for personalized surgical planning in ACDF.

Main Methods:

  • Retrospective analysis of 258 patients undergoing 1- to 3-level ACDF.
  • Radiographic assessment of preoperative and postoperative cervical alignment, disc height, and segmental lordosis.
  • Multivariable linear regression models to analyze the influence of cage design and patient alignment.

Main Results:

  • Postoperative disc height correlated positively with cage height and negatively with cage lordosis.
  • Segmental lordosis was influenced by cage height, cage lordosis, and anterior cage placement.
  • Preoperative kyphosis predicted greater postoperative lordosis correction.

Conclusions:

  • Preoperative alignment and interbody cage design are critical for optimal segmental correction in ACDF.
  • Cage height is a primary driver of disc height restoration.
  • Surgical technique, specifically anterior cage placement, is vital for enhancing segmental lordosis.