Analysis of the risk factors for loss of cervical lordosis after surgical removal of cervical spinal cord tumor.

Abstract

Loss of cervical lordosis (LOCL) is the most common postoperative cervical deformity. This study aimed to identify the predictors of LOCL by investigating the relationship between various factors and LOCL development after surgery for cervical spinal cord tumors. A retrospective analysis was conducted on 51 patients who underwent cervical spinal tumor resection at a single center. Data on the patients' cervical sagittal alignment parameters were collected both pre- and postoperatively to analyze the association between pre- and postoperative cervical sagittal alignment parameters, age, sex, pathological type of tumor, tumor location, tumor length, and likelihood of developing LOCL following cervical spinal cord surgery. Multiple logistic regression analysis revealed significant differences Pre-T1s (p = 0.005) and Post-CL (p = 0.009) angles. Additionally, ROC curves indicated a significant relationship between Post-CL and LOCL (p = 0.008, AUC = 0.718), with a Post-CL threshold value of 9.5°, and a relationship between Pre-T1s and LOCL (p = 0.025, AUC = 0.687). Tumor location, clinical staging, age, sex, and length of the segments involved in the tumor were not significantly associated with LOCL. Patients with a post-CL of less than 9.5° or Pre-T1s of more than 24.5° had a noticeably higher risk of developing LOCL. Active intervention in conjunction with surgical follow-up may be required for patients experiencing significant discomfort and associated functional impairment.