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Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty

We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present. A...

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Autores principales: Wang, Wenxuan, Xue, Chenhui, Ma, Xun, Feng, Haoyu, Ma, Zhuo, Guan, Xiaoming, Chen, Xu, Zhang, Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794331/
https://www.ncbi.nlm.nih.gov/pubmed/36595870
http://dx.doi.org/10.1097/MD.0000000000032532
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author Wang, Wenxuan
Xue, Chenhui
Ma, Xun
Feng, Haoyu
Ma, Zhuo
Guan, Xiaoming
Chen, Xu
Zhang, Xin
author_facet Wang, Wenxuan
Xue, Chenhui
Ma, Xun
Feng, Haoyu
Ma, Zhuo
Guan, Xiaoming
Chen, Xu
Zhang, Xin
author_sort Wang, Wenxuan
collection PubMed
description We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present. A retrospective study to analyze the relationship between the surgical levels and cervical sagittal parameters effects was performed in patients with cervical spondylosis myelopathy who had undergone posterior cervical expansive open-door laminoplasty with/without extending to C2. In total, 64 patients were divided into 2 groups according to the surgical levels. Radiologic outcomes of occipito-cervical angle (C0-2 Cobb angle), CL C27 Cobb angle, cervical sagittal vertical alignment, T1-Slope (T1S), T1S minus CL (T1S–CL), spino-cranial angle and center of the sella turcica–C7 SVA (St-SVA) were evaluated on lateral X-rays of the cervical spine at pre-operation, post-operation, and 2-year follow-up. The patient’s health-related quality of life was obtained including neck disability index, Japanese orthopaedic association scores, and visual analog scale. Changes in sagittal parameters were observed in both groups after surgery. T1S, cervical sagittal vertical alignment, and T1S-CL significantly increased and CL decreased in 2 groups of patients postoperative. After a 2-year follow-up period, the C0-2 Cobb angle was found to increase compared to preoperative records. In addition, there were no significant differences in spino-cranial angle and st-SVA between preoperative and 2 years follow-up measurements. Health-related quality of life was improved in both groups and was not significantly different. Herein, the parameters indicated a tilting forward of the lower cervical spine and a more lordotic upper cervical spine to maintain a horizontal gaze in patients. However, C2 to 7 laminoplasty was performed to achieve satisfactory clinical results without significantly changing the spinal sagittal parameters.
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spelling pubmed-97943312022-12-28 Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty Wang, Wenxuan Xue, Chenhui Ma, Xun Feng, Haoyu Ma, Zhuo Guan, Xiaoming Chen, Xu Zhang, Xin Medicine (Baltimore) 7100 We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present. A retrospective study to analyze the relationship between the surgical levels and cervical sagittal parameters effects was performed in patients with cervical spondylosis myelopathy who had undergone posterior cervical expansive open-door laminoplasty with/without extending to C2. In total, 64 patients were divided into 2 groups according to the surgical levels. Radiologic outcomes of occipito-cervical angle (C0-2 Cobb angle), CL C27 Cobb angle, cervical sagittal vertical alignment, T1-Slope (T1S), T1S minus CL (T1S–CL), spino-cranial angle and center of the sella turcica–C7 SVA (St-SVA) were evaluated on lateral X-rays of the cervical spine at pre-operation, post-operation, and 2-year follow-up. The patient’s health-related quality of life was obtained including neck disability index, Japanese orthopaedic association scores, and visual analog scale. Changes in sagittal parameters were observed in both groups after surgery. T1S, cervical sagittal vertical alignment, and T1S-CL significantly increased and CL decreased in 2 groups of patients postoperative. After a 2-year follow-up period, the C0-2 Cobb angle was found to increase compared to preoperative records. In addition, there were no significant differences in spino-cranial angle and st-SVA between preoperative and 2 years follow-up measurements. Health-related quality of life was improved in both groups and was not significantly different. Herein, the parameters indicated a tilting forward of the lower cervical spine and a more lordotic upper cervical spine to maintain a horizontal gaze in patients. However, C2 to 7 laminoplasty was performed to achieve satisfactory clinical results without significantly changing the spinal sagittal parameters. Lippincott Williams & Wilkins 2022-12-23 /pmc/articles/PMC9794331/ /pubmed/36595870 http://dx.doi.org/10.1097/MD.0000000000032532 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 7100
Wang, Wenxuan
Xue, Chenhui
Ma, Xun
Feng, Haoyu
Ma, Zhuo
Guan, Xiaoming
Chen, Xu
Zhang, Xin
Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title_full Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title_fullStr Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title_full_unstemmed Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title_short Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
title_sort extension of decompression to c2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794331/
https://www.ncbi.nlm.nih.gov/pubmed/36595870
http://dx.doi.org/10.1097/MD.0000000000032532
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