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KMID : 0388720220290040097
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Journal of Korean Society of Spine Surgery
2022 Volume.29 No. 4 p.97 ~ p.106
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Predictors of Postoperative Loss of Cervical Lordosis after Cervical Laminoplasty for Cervical Spondylotic Myelopathy
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Ahn Joong-Hyun
Cho Chang-Hee
Ha Kee-Yong
Kim Sang-Il
Park Hyung-Youl
Kim Hun-Chul
Yang Jun-Seo
Kim Young-Hoon
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Abstract
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Study Design: Retrospective cohort study.
Objectives: To investigate the correlation between the loss of cervical lordosis (LCL) after laminoplasty and the preoperative status of posterior cervical intrinsic muscles and sagittal parameters.
Summary of Literature Review: Previous studies have reported that higher T1 slope and high cervical lordosis were related to LCL after laminoplasty.
Materials and Methods: Thirty-nine patients who underwent open door cervical laminoplasty at a single institution between January 2005 and April 2019 were included. In addition to general clinical parameters, the radiological parameters were evaluated. The preoperative properties of cervical intrinsic muscles were estimated by the three-dimensional approximated volume and the ratio of functional cross-sectional area (FCSA) considering fatty infiltration to the total cross-sectional area (TCSA). LCL was defined as a loss of more than 1° in the C2-C7 angle on postoperative 1-year radiographs. The clinical results were also evaluated.
Results: Eighteen patients exhibited LCL (group I), and 21 patients showed maintained cervical lordosis (group II). Group I had a significantly higher preoperative C2-C7 angle (7.2°±13.6°) than group II (-8.5°±12.6°). However, the volume and FCSA/TCSA ratio of the intrinsic muscles were not significantly different between the groups except for FCSA/TCSA at the C3-C4 level. In multivariable logistic regression analysis, a high preoperative C2-C7 angle (odds ratio, 1.114; 95% confidence interval, 1.037-1.195, p=0.003) was the only factor related to LCL.
Conclusions: Although large preoperative C2-C7 lordosis was related to LCL, the preoperative status of posterior cervical muscles was not an independent risk factor for LCL after laminoplasty.
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KEYWORD
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Cervical spondylotic myelopathy, Laminoplasty, Loss of cervical lordosis, T1 slope
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