Preoperative Parameters for Predicting the Loss of Lordosis After Cervical Laminoplasty

Kim, Kwang-Ryeol; Lee, Chang Kyu; Park, Jeong Yoon; Kim, In-Soo

doi:10.1097/brs.0000000000003604

Cited by 26 publications

(35 citation statements)

References 41 publications

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“…Kim et al (2020) in their retrospective study attempted to recognize predisposing factors of loss of cervical lordosis in 106 patients that underwent a cervical laminoplasty procedure [ 26 ]. Authors divided their patients in 38 that preserved cervical lordosis and in 68 patients that lost cervical lordosis.…”

Section: Resultsmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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Cervical spine musculature still remains a less studied component of the cervical spine anatomical compartments, although it plays a significant role in the mobility of the head and the preservation of cervical spine alignment. The goal of this study was to extract any significant information from the literature regarding the role of cervical spine muscles morphology in the outcome of surgically treated patients for degenerative disc disease (DDD) based on preoperative magnetic resonance imaging (MRI) studies. Eleven clinical case series were found, from which four were prospective and seven were retrospective. Six studies were concentrated on anterior approaches and five studies on posterior approaches in the cervical spine. In posterior approaches aiming at the preservation of muscles attachments and overall less surgical manipulations, results on cervical lordosis, axial pain and patient's functionality were found superior to traditional laminectomies. The study of cross-sectional areas (CSAs) of deep paraspinal muscles in the cervical spine could add significant information for the spine surgeon such as the prediction of adjacent level disease (ALD), fusion failure, axial pain persistence, postoperative cervical alignment and patient's postoperative functionality. It seems that MRI studies focusing on muscle layers of the cervical spine could add significant information for the spinal surgeon regarding the final surgical outcome in terms of pain and function expres-sion. Larger multicenter clinical studies are a necessity in defining the role of the muscle component of the cervical spine in the surgical treatment of DDD.

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Section: Resultsmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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“…According to previous studies, preoperative cross-sectional area and fatty degeneration of paraspinal muscle were correlated with loss of lordosis in laminoplasty [ 14 , 20 ]. Cervical paraspinal extensor muscles have been shown to contribute to maintaining cervical spine stability [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative cervical sagittal alignment is affected by many factors, such as the type of implant system, distraction degree, intraoperative procedure, and paraspinal muscle status [ 11 – 14 ]. Theoretically, to maintain a forward gaze position, the posterior extensor muscles of the neck need to be contracted [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Posterior cervical surgery for cervical degenerative disc disease (CDDD) could injure the posterior paraspinal muscle, which has been linked with postoperative axial symptoms [ 18 ]. In addition, a low preoperative cross-sectional area of the posterior extensor muscle is a risk factor for postoperative loss of lordosis [ 14 , 19 , 20 ]. Therefore, attention should be given to posterior extensor muscles status in cervical spine surgery.…”

Section: Introductionmentioning

confidence: 99%

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Fatty infiltration in cervical extensor muscle: is there a relationship with cervical sagittal alignment after anterior cervical discectomy and fusion?

Wang

Huang

et al. 2022

BMC Musculoskelet Disord

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Purpose To investigate the relationship between the preoperative paraspinal Goutalier grade of fatty infiltration and postoperative cervical sagittal alignment in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods A total of 101 patients who underwent single-level ACDF with the Zero-profile implant system between March 2011 and April 2020 were included in this study. Cervical sagittal alignment parameters, including the C2-C7 Cobb angle, functional spinal unit (FSU) angle, cervical sagittal vertical axis (SVA), and T1 slope (T1S), were assessed. Preoperative magnetic resonance images were used to classify patients according to Goutalier grade. Clinical outcomes including Neck Disability Index (NDI) scores, Japanese Orthepaedic Association (JOA) scores and Visual Analogue Scale (VAS) scores were collected and analyzed. Results According to the Goutalier grade, 33 patients were classified as Goutalier 0–1 (Group A), 44 were classified as Goutalier 1.5–2 (Group B), and 24 were classified as Goutalier 2.5–4.0 (Group C). The mean age among the three groups showed significant differences (P = 0.007). At the last follow-up, the C2-C7 Cobb angle, FSU angle, and T1S improved after the surgery among the groups. Although there were varying degrees of loss of curvature among the different groups during the follow-up period, the postoperative cervical sagittal alignment parameters demonstrated no statistical differences among the three groups (P > 0.05). In addition, patients in all groups experienced significant relief of their symptoms, and the clinical scores were comparable among the groups (P > 0.05). Conclusion The complex nature of anterior cervical surgery requires surgical attention both in decompression and sagittal alignment. Our study demonstrates satisfactory postoperative cervical sagittal alignment of patients despite different grades of fatty infiltration of the multifidus muscle following single-level ACDF. Based on our results, the improvement and maintenance of cervical sagittal alignment after ACDF remains a complex problem that spine surgeons should consider before surgery.

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“…The loss of cervical kyphosis leads to increasing the length and decreasing the CSA of the neck extensors. Studies found that cervical lordosis was correlated with fat infiltration of deep neck extensors (multifidus, spinalis cervicis, and capitis) at the C4/5 and C7/T1 segments [ 62 ] but not at C5/6 [ 63 ]. Xing-Jin Wang et al [ 64 ] found no differences in cervical lordosis angle in patients with more extensor muscle fat infiltration.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Fat Infiltration of Multifidus Muscle Is Correlated with Neck Disability in Patients with Non-Specific Chronic Neck Pain

Grondin

Freppel

Jull

et al. 2022

JCM

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Chronic non-specific neck pain (CINP) is common, but the etiology remains unclear. This study aimed to examine the relationship between cervical muscle composition (cervical multifidus and longus capitis/longus colli), morphometry, range of movement, muscle function, and disability severity (Neck Disability Index) in patients with CINP. Methods: From September 2020 to July 2021, subjects underwent cervical MRI and clinical tests (cervical range of motion, cranio-cervical flexion test, neck flexor, and extensor muscle endurance). MRI analysis comprised muscle cross-sectional area, volume, and fat infiltration of multifidus and longus colli between C4 and C7 levels. Results: Twenty-five participants were included. Multiple linear regression analysis indicated that NDI was positively correlated with the volume percentage of fat infiltration of the multifidus (B = 0.496), negatively correlated with fat-free muscle volume of the multifidus normalized by subject height (B = −0.230), and accounted for 32% of the variance. There was no relationship between neck disability and longus capitis/longus colli morphology. We also found no relationship between neck disability scores, neck flexor or extensor muscle endurance, or the outcome motor control test of craniocervical flexion (p > 0.05). Conclusions: Neck disability was moderately correlated with the percentage of fat volume in the multifidus muscle and fat-free volume of the multifidus. There was no relationship between NDI scores and muscle function test outcomes or any fat or volume measures pertaining to the longus colli muscle.

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Preoperative Parameters for Predicting the Loss of Lordosis After Cervical Laminoplasty

Cited by 26 publications

References 41 publications

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

Fatty infiltration in cervical extensor muscle: is there a relationship with cervical sagittal alignment after anterior cervical discectomy and fusion?

Fat Infiltration of Multifidus Muscle Is Correlated with Neck Disability in Patients with Non-Specific Chronic Neck Pain

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