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Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy.
Spine (Phila Pa 1976). 2003 Jun 15; 28(12):1258-62.S

Abstract

STUDY DESIGN

This retrospective study analyzed the effects of cervical alignment on surgical results of expansive laminoplasty (ELAP) for cervical spondylotic myelopathy (CSM).

OBJECTIVE

To determine the limitation of posterior decompression by ELAP for CSM in the presence of local kyphosis.

SUMMARY OF BACKGROUND DATA

Several studies have reported that cervical malalignment affected surgical outcomes of ELAP. However, there has been no report to demonstrate crucial determinants of surgical outcomes of ELAP for CSM in relation to cervical sagittal alignment.

METHODS

The study group comprised 114 patients who underwent ELAP for CSM. All were followed up for more than 2 years. The Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy (full score, 17 points) was used to evaluate surgical outcomes for each patient 2 years after surgery. Statistical analysis with multivariate logistic regression models was used to ascertain the risk factors affecting postoperative surgical outcomes.

RESULTS

The average JOA scores were 9.9 points before surgery and 14 points 2 years after surgery. The recovery rate was 60.2%. Statistical analysis showed that signal intensity change on MRI and local kyphosis were the most crucial risk factors for poor surgical outcomes. Calculated with the logistic regression model, the highest risk of poor recovery was local kyphosis exceeding 13 degrees.

CONCLUSIONS

The influence of cervical malalignment on neurologic recovery after ELAP for CSM was shown. When patients have local kyphosis exceeding 13 degrees, anterior decompression or posterior correction of kyphosis as well as ELAP should be considered. Expansive laminoplasty for CSM is best indicated for patients with local kyphosis less than 13 degrees.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. sudako@med.hokudai.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12811268

Citation

Suda, Kota, et al. "Local Kyphosis Reduces Surgical Outcomes of Expansive Open-door Laminoplasty for Cervical Spondylotic Myelopathy." Spine, vol. 28, no. 12, 2003, pp. 1258-62.
Suda K, Abumi K, Ito M, et al. Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2003;28(12):1258-62.
Suda, K., Abumi, K., Ito, M., Shono, Y., Kaneda, K., & Fujiya, M. (2003). Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine, 28(12), 1258-62.
Suda K, et al. Local Kyphosis Reduces Surgical Outcomes of Expansive Open-door Laminoplasty for Cervical Spondylotic Myelopathy. Spine (Phila Pa 1976). 2003 Jun 15;28(12):1258-62. PubMed PMID: 12811268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. AU - Suda,Kota, AU - Abumi,Kuniyoshi, AU - Ito,Manabu, AU - Shono,Yasuhiro, AU - Kaneda,Kiyoshi, AU - Fujiya,Masanori, PY - 2003/6/18/pubmed PY - 2004/1/30/medline PY - 2003/6/18/entrez SP - 1258 EP - 62 JF - Spine JO - Spine (Phila Pa 1976) VL - 28 IS - 12 N2 - STUDY DESIGN: This retrospective study analyzed the effects of cervical alignment on surgical results of expansive laminoplasty (ELAP) for cervical spondylotic myelopathy (CSM). OBJECTIVE: To determine the limitation of posterior decompression by ELAP for CSM in the presence of local kyphosis. SUMMARY OF BACKGROUND DATA: Several studies have reported that cervical malalignment affected surgical outcomes of ELAP. However, there has been no report to demonstrate crucial determinants of surgical outcomes of ELAP for CSM in relation to cervical sagittal alignment. METHODS: The study group comprised 114 patients who underwent ELAP for CSM. All were followed up for more than 2 years. The Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy (full score, 17 points) was used to evaluate surgical outcomes for each patient 2 years after surgery. Statistical analysis with multivariate logistic regression models was used to ascertain the risk factors affecting postoperative surgical outcomes. RESULTS: The average JOA scores were 9.9 points before surgery and 14 points 2 years after surgery. The recovery rate was 60.2%. Statistical analysis showed that signal intensity change on MRI and local kyphosis were the most crucial risk factors for poor surgical outcomes. Calculated with the logistic regression model, the highest risk of poor recovery was local kyphosis exceeding 13 degrees. CONCLUSIONS: The influence of cervical malalignment on neurologic recovery after ELAP for CSM was shown. When patients have local kyphosis exceeding 13 degrees, anterior decompression or posterior correction of kyphosis as well as ELAP should be considered. Expansive laminoplasty for CSM is best indicated for patients with local kyphosis less than 13 degrees. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/12811268/Local_kyphosis_reduces_surgical_outcomes_of_expansive_open_door_laminoplasty_for_cervical_spondylotic_myelopathy_ L2 - https://doi.org/10.1097/01.BRS.0000065487.82469.D9 DB - PRIME DP - Unbound Medicine ER -