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Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature.
Spine (Phila Pa 1976). 2012 Sep 15; 37(20):E1243-50.S

Abstract

STUDY DESIGN

A large-scale analysis of radiographical results of patients with cervical spondylotic myelopathy and a review of the literature.

OBJECTIVE

To identify changes in sagittal alignment and range of motion (ROM) after cervical laminoplasty.

SUMMARY OF BACKGROUND DATA

Cervical laminoplasty is an effective procedure for decompressing multilevel spinal cord compression. It often induces postoperative complications such as loss of lordotic alignment and restriction of neck motion. Although numerous studies have reported the loss of flexion-extension ROM after laminoplasty, no large-scale study has been reported.

METHODS

Five hundred twenty consecutive patients with cervical spondylotic myelopathy (331 male and 189 female; mean age, 62.2 yr) who underwent modified double-door laminoplasty were enrolled. The average follow-up period was 33.3 months. All patients were allowed to sit up and walk on the first postoperative day using an orthosis, which could be removed within the first 2 weeks, even if long. Early cervical ROM exercises were performed as a part of the rehabilitation schedule. Radiography was performed before surgery and at the final follow-up. Cervical alignment in the neutral and flexion-extension view were measured by the Cobb method at C2-C7. The ROM was assessed by measuring the difference in alignment between flexion and extension.

RESULTS

The mean C2-C7 alignment in the neutral position was 11.9° lordotic preoperatively and 13.6° lordotic postoperatively; the alignment increased by 1.8° in lordosis. The mean total ROM decreased from a preoperative value of 40.1° to 33.5° at the final follow-up, showing a significant difference of 6.6°. The mean total ROM preservation after laminoplasty was 87.9%.

CONCLUSION

Sagittal alignment was slightly changed, with only a 1.8° increase in lordosis. The ROM of the cervical spine was preserved by 87.9%. This preservation of alignment and ROM might be attributable to improvements including early removal of the cervical orthosis, postoperative neck exercises, and some surgical modifications.

Authors+Show Affiliations

Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Japan. masaaki_machino_5445_2@yahoo.co.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22739671

Citation

Machino, Masaaki, et al. "Cervical Alignment and Range of Motion After Laminoplasty: Radiographical Data From More Than 500 Cases With Cervical Spondylotic Myelopathy and a Review of the Literature." Spine, vol. 37, no. 20, 2012, pp. E1243-50.
Machino M, Yukawa Y, Hida T, et al. Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature. Spine. 2012;37(20):E1243-50.
Machino, M., Yukawa, Y., Hida, T., Ito, K., Nakashima, H., Kanbara, S., Morita, D., & Kato, F. (2012). Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature. Spine, 37(20), E1243-50.
Machino M, et al. Cervical Alignment and Range of Motion After Laminoplasty: Radiographical Data From More Than 500 Cases With Cervical Spondylotic Myelopathy and a Review of the Literature. Spine. 2012 Sep 15;37(20):E1243-50. PubMed PMID: 22739671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature. AU - Machino,Masaaki, AU - Yukawa,Yasutsugu, AU - Hida,Tetsuro, AU - Ito,Keigo, AU - Nakashima,Hiroaki, AU - Kanbara,Shunsuke, AU - Morita,Daigo, AU - Kato,Fumihiko, PY - 2012/6/29/entrez PY - 2012/6/29/pubmed PY - 2013/2/5/medline SP - E1243 EP - 50 JF - Spine JO - Spine VL - 37 IS - 20 N2 - STUDY DESIGN: A large-scale analysis of radiographical results of patients with cervical spondylotic myelopathy and a review of the literature. OBJECTIVE: To identify changes in sagittal alignment and range of motion (ROM) after cervical laminoplasty. SUMMARY OF BACKGROUND DATA: Cervical laminoplasty is an effective procedure for decompressing multilevel spinal cord compression. It often induces postoperative complications such as loss of lordotic alignment and restriction of neck motion. Although numerous studies have reported the loss of flexion-extension ROM after laminoplasty, no large-scale study has been reported. METHODS: Five hundred twenty consecutive patients with cervical spondylotic myelopathy (331 male and 189 female; mean age, 62.2 yr) who underwent modified double-door laminoplasty were enrolled. The average follow-up period was 33.3 months. All patients were allowed to sit up and walk on the first postoperative day using an orthosis, which could be removed within the first 2 weeks, even if long. Early cervical ROM exercises were performed as a part of the rehabilitation schedule. Radiography was performed before surgery and at the final follow-up. Cervical alignment in the neutral and flexion-extension view were measured by the Cobb method at C2-C7. The ROM was assessed by measuring the difference in alignment between flexion and extension. RESULTS: The mean C2-C7 alignment in the neutral position was 11.9° lordotic preoperatively and 13.6° lordotic postoperatively; the alignment increased by 1.8° in lordosis. The mean total ROM decreased from a preoperative value of 40.1° to 33.5° at the final follow-up, showing a significant difference of 6.6°. The mean total ROM preservation after laminoplasty was 87.9%. CONCLUSION: Sagittal alignment was slightly changed, with only a 1.8° increase in lordosis. The ROM of the cervical spine was preserved by 87.9%. This preservation of alignment and ROM might be attributable to improvements including early removal of the cervical orthosis, postoperative neck exercises, and some surgical modifications. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/22739671/Cervical_alignment_and_range_of_motion_after_laminoplasty:_radiographical_data_from_more_than_500_cases_with_cervical_spondylotic_myelopathy_and_a_review_of_the_literature_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3182659d3e DB - PRIME DP - Unbound Medicine ER -