Curvature and Range of Motion of the Cervical Spine After Laminaplasty*

Aita, Ikuo; Wadano, Yasuyoshi; Yabuki, Takeshi

doi:10.2106/00004623-200012000-00008

Cited by 43 publications

(13 citation statements)

References 12 publications

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“…7,8 The increase in spinal canal space provided by this procedure is 85% in sagittal diameter 8 and 36% in cross-sectional area, 7 suggesting the potential for an increase in spinal canal volume, causing some kinetic alteration of the spinal cord. Although kinetic changes of the cervical spine after laminoplasty were described previously, 13 to our knowledge, there are no previous ki- The data in the present study indicate that the cord of the patients after laminoplasty moved dorsally toward the expanded posterior elements of the spinal canal and retain its dorsal position in the dilated spinal canal at any of the flexed, neutral, or extended spinal positions. Baba et al 14 reported that the spinal cord shifts posteriorly because of the increase of cervical spine lordosis following laminoplasty, and postulated a strong relation between postoperative neurologic improvement and posterior cord migration.…”

Section: Discussionsupporting

confidence: 43%

Kinetic Analysis of the Cervical Spinal Cord in Patients After Spinous Process-Splitting Laminoplasty Using a Kinematic Magnetic Resonance Imaging Technique

Miyata

Marui²,

Miura³

et al. 2006

Spine

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Section: Discussionsupporting

confidence: 43%

Kinetic Analysis of the Cervical Spinal Cord in Patients After Spinous Process-Splitting Laminoplasty Using a Kinematic Magnetic Resonance Imaging Technique

Miyata

Marui²,

Miura³

et al. 2006

Spine

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“…After conventional (no sparing of muscle insertions) C3-7 laminoplasty, loss of C2-7 angle has been reported to reach 6.2 to 11.7 degrees. [15][16][17] Kyphotic deformity often develops after laminectomy from C1 or C2 to the subaxial cervical spine. 18 Biomechanical analysis showed that the semispinalis cervicis and C2 lamina play an important role in dynamically stabilizing the cervical spine and that a loss of cervical lordosis results from detachment of the semispinalis attached to the C2 spinous process, 19 suggesting that a loss of cervical lordosis after laminoplasty mainly results from detachment of muscles attached to the C2 spinous process.…”

Section: Discussionmentioning

confidence: 99%

C3–6 Laminoplasty for Cervical Spondylotic Myelopathy Maintains Satisfactory Long-Term Surgical Outcomes

Sakaura

Hosono

Mukai

et al. 2014

Global Spine Journal

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Study Design Prospective cohort study. Objective To clarify long-term surgical outcomes of C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3–6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study. Myelopathic symptoms were assessed using Japanese Orthopaedic Association (JOA) score. Axial neck pain was graded as severe, moderate, or mild. C2–7 angle was measured using lateral radiographs of the cervical spine before surgery and at final follow-up. Results Mean JOA score before surgery (11.7) was significantly improved to 15.2 at the time of maximum recovery (1 year after surgery), declining slightly to 14.9 by the latest follow-up. Late deterioration of JOA score developed in eight patients, but was unrelated to the cervical spine lesions in each case. No patient suffered from prolonged postoperative axial neck pain at final follow-up. The mean C2–7 angle before surgery (13.8 degrees) significantly increased to 19.2 degrees at final follow-up. Conclusions C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with CSM maintained satisfactory long-term neurologic improvement with significantly reduced frequencies of prolonged postoperative axial neck pain and loss of C2–7 angle after surgery.

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“…The C2-7 angle can reach 6.2°-11.7° after conventional surgery. 1,23,37 In addition, cervical ROM is reportedly reduced to 30%-70% of the preoperative value following laminoplasty. 2,6,27 Several authors have recommended that the insertion of the semispinalis into C-2 should be preserved during laminoplasty.…”

Section: Sagittal Alignment and Rommentioning

confidence: 99%

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

Umeda

Sasai

Kushida

et al. 2013

SPI

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Object Modified cervical laminoplasty techniques have been developed to reduce postoperative axial neck pain and preserve function in patients with cervical spondylotic myelopathy (CSM). However, the previous studies demonstrating satisfactory surgical outcomes had a retrospective design. Here, the authors aimed to prospectively evaluate the 2-year outcomes of a modified cervical laminoplasty technique for CSM that preserves the paravertebral muscles. Methods Outcomes were analyzed for 40 patients (22 men and 18 women; mean age, 66.6 years; age range 44–92 years) with CSM who underwent C4–6 laminoplasty with C-3 and C-7 partial laminectomies or C-3 total and C-7 partial laminectomies and received hydroxyapatite spacers. Neurological, pain severity, and spinal radiographic evaluations were performed preoperatively and at 3, 6, 12, 18, and 24 months postoperatively. Plain radiography and MRI of the cervical spine were performed to evaluate the range of motion (ROM), sagittal alignment, and cross-sectional areas of the deep extensor muscles. The extent of bone–spacer bonding and bony union at the gutter was assessed by CT. Results The mean preoperative Japanese Orthopaedic Association CSM score was 10.2, but it increased to 14.4 by 24 months after surgery. Eleven patients had axial neck pain preoperatively, but only 3 reported mild pain at 24 months, and in all 3 cases the pain was mild. The mean angle of lordosis was 11.7° preoperatively and 12.0° 2 years postoperatively. Although the ROM at the C2–7 levels was significantly reduced 3 months postoperatively, an increasing trend was observed up to 12 months, and 86% of the preoperative ROM was achieved by 2 years postoperatively. The mean paravertebral muscle cross-sectional areas were 833 ± 215 mm2 preoperatively and 763 ± 197 mm2 24 months postoperatively, but the difference was not statistically significant. The rates of bone–spacer bonding and bony union at the gutter were low during the early stages but increased to 90% and 93%, respectively, by 2 years after surgery. Conclusions The modified laminoplasty technique used in this study ensured very good neurological status and ROM after 2 years and was associated with low incidences of axial neck pain and serious complications. This simple and easy operative method could benefit future laminoplasty protocols.

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Curvature and Range of Motion of the Cervical Spine After Laminaplasty*

Cited by 43 publications

References 12 publications

Kinetic Analysis of the Cervical Spinal Cord in Patients After Spinous Process-Splitting Laminoplasty Using a Kinematic Magnetic Resonance Imaging Technique

Kinetic Analysis of the Cervical Spinal Cord in Patients After Spinous Process-Splitting Laminoplasty Using a Kinematic Magnetic Resonance Imaging Technique

C3–6 Laminoplasty for Cervical Spondylotic Myelopathy Maintains Satisfactory Long-Term Surgical Outcomes

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

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