This study aims to investigate the relationship between preoperative cervical spine alignment and changes in postoperative myelopathy after surgery in patients with cervical myelopathy who underwent anterior cervical corpectomy and fusion (ACCF) surgery as treatment.

Patients who underwent anterior cervical corpectomy and fusion surgery for the treatment of cervical myelopathy were included in the study. We evaluated various cervical alignment parameters such as T1 sagittal angle, T1 slope, and C2–7 sagittal vertical axis (SVA) before surgery. Postoperative myelopathy outcomes were assessed using the Modified Japanese Orthopedic Association score (mJOA), Neck Disability Index (NDI), and Visual Analog Scale (VAS). Statistical analysis was performed using Pearson correlation coefficient and multiple linear regression to determine the relationship between preoperative radiological parameters and postoperative clinical outcomes.

There were no significant differences in age, gender, or BMI between the single-level and multilevel corpectomy groups. Significant differences were observed in postoperative C2–7 Cobb angle, operative time, and blood loss. Patients with higher C2–7 SVA had worse operative outcomes.

Preoperative cervical alignment measurements such as T1 slope and C2–7 SVA may be helpful in predicting myelopathy outcomes after ACCF surgery. Predicting the clinical outcomes of the patient after surgery is important for preparing postoperative care and adjusting treatment.