Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Lee, Su Hun; Son, Dong Wuk; Shin, Jun Jae; Ha, Yoon; Song, Geun Sung; Lee, Jung Hoon; Lee, Sang Weon

doi:10.3340/jkns.2020.0294

Cited by 5 publications

(4 citation statements)

References 73 publications

(115 reference statements)

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“…23 Preoperative T1S and C2-C7 SVA do not predict changes in cervical curvature after laminoplasty. 24,25 Similarly to the previous studies, we discovered that preoperative T1S and C2-C7 SVA had no significant correlation with postoperative cervical kyphosis.…”

Section: Discussionsupporting

confidence: 73%

“…However, some investigators have found no significant correlation between the loss of cervical curvature and preoperative T1S 23 . Preoperative T1S and C2–C7 SVA do not predict changes in cervical curvature after laminoplasty 24,25 . Similarly to the previous studies, we discovered that preoperative T1S and C2–C7 SVA had no significant correlation with postoperative cervical kyphosis.…”

Section: Discussionsupporting

confidence: 71%

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Preoperative Range of Motion in Extension May Influence Postoperative Cervical Kyphosis After Laminoplasty

Ren

Shen

Ding

et al. 2023

Spine

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Study Design. Retrospective observational study.Objective. The objective of this study was to investigate factors associated with cervical kyphosis after laminoplasty. Summary of Background Data. Many factors are reportedly associated with the deterioration of cervical curvature after laminoplasty, including cervical lordosis angle, cervical spine range of motion (ROM), T1 slope, and C2-C7 sagittal vertical axis. Postlaminoplasty kyphosis or deterioration of cervical curvature is likely caused by multiple factors. There is currently no consensus on these issues. Materials and Methods. Data of patients treated with laminoplasty for degenerative cervical myelopathy at our institution during 2008-2018 were reviewed. The following variables were collected for each patient: age and sex; follow-up time; surgery involving C3 (yes or no); surgery involving C7 (yes or no); distribution of segments operated on; number of laminae operated on; flexion, extension, and total ROM; cervical lordotic angle; longitudinal distance index; curvature index; C2-C7 sagittal vertical axis; and T1 slope. Logistic regression analysis was used to assess possible risk factors for postoperative kyphosis. Receiver operating characteristic curves were constructed to determine the cutoff values of risk factors.Results. The study cohort comprised 151 patients. Logistic regression analysis indicated that sex, number of laminae operated on, and preoperative extension ROM were significantly associated with postoperative cervical kyphosis (P < 0.05). There was significantly greater postoperative kyphosis in women than in men; the more segments operated on, the greater the risk of postoperative kyphosis, and the larger the preoperative extension ROM, the lower the risk of postlaminoplasty kyphosis. Receiver operating characteristic curve analysis showed that the cutoff value for preoperative extension ROM is 22.1°. Conclusions. Preoperative extension ROM may be associated with the development of postoperative kyphosis. The cutoff value of preoperative extension ROM that suggested the prospect of postoperative kyphosis in our sample was 22.1°.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 71%

Preoperative Range of Motion in Extension May Influence Postoperative Cervical Kyphosis After Laminoplasty

Ren

Shen

Ding

et al. 2023

Spine

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“…The relationships between preoperative radiographic parameters and loss of cervical lordosis following laminoplasty have been fairly well studied. Several studies have concluded that a high T1 slope and the difference between T1 slope and C2-C7 lordosis can predict the loss of lordosis following laminoplasty [9][10][11][12][13][14][15][16][17][18]. The relationship between loss of cervical lordosis following laminoplasty and spinal parameters beyond the regional cervical spine on full-length scoliosis X-rays (i.e., pelvic incidence, lumbar lordosis, sagittal vertical axis from C7-S1) have been understudied by comparison.…”

Section: Introductionmentioning

confidence: 99%

Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?

Macki,

Chryssikos,

Meade

et al. 2023

JCM

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Introduction: In a multilevel cervical laminoplasty operation for patients with cervical spondylotic myelopathy (CSM), a partial or complete C3 laminectomy may be performed at the upper level instead of a C3 plated laminoplasty. It is unknown whether C3 technique above the laminoplasty affects loss of cervical lordosis or range of motion. Methods: Patients undergoing multilevel laminoplasty of the cervical spine (C3–C6/C7) at a single institution were retrospectively reviewed. Patients were divided into two cohorts based on surgical technique at C3: C3–C6/C7 plated laminoplasty (“C3 laminoplasty only”, N = 61), C3 partial or complete laminectomy, plus C4–C6/C7 plated laminoplasty (N = 39). All patients had at least 1-year postoperative X-ray treatment. Results: Of 100 total patients, C3 laminoplasty and C3 laminectomy were equivalent in all demographic data, except for age (66.4 vs. 59.4 years, p = 0.012). None of the preoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (13.1° vs. 11.1°, p = 0.259), T1 slope (32.9° vs. 29.2°, p = 0.072), T1 slope–cervical lordosis (19.8° vs. 18.6°, p = 0.485), or cervical sagittal vertical axis (3.1 cm vs. 2.7 cm, p = 0.193). None of the postoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (9.4° vs. 11.2°, p = 0.369), T1 slope–cervical lordosis (21.7° vs. 18.1°, p = 0.126), to cervical sagittal vertical axis (3.3 cm vs. 3.6 cm, p = 0.479). In the total cohort, 31% had loss of cervical lordosis >5°. Loss of lordosis reached 5–10° (mild change) in 13% of patients and >10° (moderate change) in 18% of patients. C3 laminoplasty and C3 laminectomy cohorts did not differ with respect to no change (<5°: 65.6% vs. 74.3%, respectively), mild change (5–10°: 14.8% vs. 10.3%), and moderate change (>10°: 19.7% vs. 15.4%) in cervical lordosis, p = 0.644. When controlling for age, ordinal regression showed that surgical technique at C3 did not increase the odds of postoperative loss of cervical lordosis. C3 laminectomy versus C3 laminoplasty did not differ in the postoperative range of motion on cervical flexion–extension X-rays (23.9° vs. 21.7°, p = 0.451, N = 91). Conclusion: There was no difference in postoperative loss of cervical lordosis or postoperative range of motion in patients who underwent either C3–C6/C7 plated laminoplasty or C3 laminectomy plus C4–C6/C7 plated laminoplasty.

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“…With regard to the pathogenesis of OPLL, on one hand, OPLL demonstrates racial differences in its incidence, which is especially high in East Asian males [ 10 , 11 ]. A previous study in North America showed that the prevalence of OPLL varied among races: 4.8% in Asian Americans, 1.3% in Caucasian Americans, 1.9% in Hispanic Americans, and 3.2% in Native Americans [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Genetic Odyssey to Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Systematic Review

et al. 2022

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Despite numerous studies, the pathogenesis of ossification of the posterior longitudinal ligament (OPLL) is still unclear. Previous genetic studies proposed variations in genes related to bone and collagen as a cause of OPLL. It is unclear whether the upregulations of those genes are the cause of OPLL or an intermediate result of endochondral ossification process. Causal variations may be in the inflammation-related genes supported by clinical and updated genomic studies. OPLL demonstrates features of genetic diseases but can also be induced by mechanical stress by itself. OPLL may be a combination of various diseases that share ossification as a common pathway and can be divided into genetic and idiopathic. The phenotype of OPLL can be divided into continuous (including mixed) and segmental (including localized) based on the histopathology, prognosis, and appearance. Continuous OPLL shows substantial overexpression of osteoblast-specific genes, frequent upper cervical involvement, common progression, and need for surgery, whereas segmental OPLL shows moderate-to-high expression of these genes and is often clinically silent. Genetic OPLL seems to share clinical features with the continuous type, while idiopathic OPLL shares features with the segmental type. Further genomic studies are needed to elucidate the relationship between genetic OPLL and phenotype of OPLL.

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Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty

Cited by 5 publications

References 73 publications

Preoperative Range of Motion in Extension May Influence Postoperative Cervical Kyphosis After Laminoplasty

Preoperative Range of Motion in Extension May Influence Postoperative Cervical Kyphosis After Laminoplasty

Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?

Genetic Odyssey to Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Systematic Review

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