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Range of motion loss after cervical laminoplasty: a prospective study with minimum 5-year follow-up data.
Spine J. 2013 Apr; 13(4):384-90.SJ

Abstract

BACKGROUND CONTEXT

Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period.

PURPOSE

We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty.

STUDY DESIGN

A prospective cohort study.

PATIENT SAMPLE

The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study.

OUTCOME MEASURES

The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome.

METHODS

Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up.

RESULTS

The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9 ± 11.2°, 35.0 ± 9.2°, 33.0 ± 11.0°, 30.1 ± 10.4°, 25.8 ± 13.1°, 24.7 ± 10.0°, 23.8 ± 6.5°, 24.6 ± 8.3°, and 23.6 ± 9.4°, respectively, and at the most recent follow-up, ROM was 24.5 ± 10.1°. Thus, the mean ROM decreased by 15.4 ± 8.4° (38.5%) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2% vs. 72.7%). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6% decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4% decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM.

CONCLUSIONS

These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs.

Authors+Show Affiliations

Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23218824

Citation

Hyun, Seung-Jae, et al. "Range of Motion Loss After Cervical Laminoplasty: a Prospective Study With Minimum 5-year Follow-up Data." The Spine Journal : Official Journal of the North American Spine Society, vol. 13, no. 4, 2013, pp. 384-90.
Hyun SJ, Riew KD, Rhim SC. Range of motion loss after cervical laminoplasty: a prospective study with minimum 5-year follow-up data. Spine J. 2013;13(4):384-90.
Hyun, S. J., Riew, K. D., & Rhim, S. C. (2013). Range of motion loss after cervical laminoplasty: a prospective study with minimum 5-year follow-up data. The Spine Journal : Official Journal of the North American Spine Society, 13(4), 384-90. https://doi.org/10.1016/j.spinee.2012.10.037
Hyun SJ, Riew KD, Rhim SC. Range of Motion Loss After Cervical Laminoplasty: a Prospective Study With Minimum 5-year Follow-up Data. Spine J. 2013;13(4):384-90. PubMed PMID: 23218824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Range of motion loss after cervical laminoplasty: a prospective study with minimum 5-year follow-up data. AU - Hyun,Seung-Jae, AU - Riew,K Daniel, AU - Rhim,Seung-Chul, Y1 - 2012/12/06/ PY - 2011/11/22/received PY - 2012/06/23/revised PY - 2012/10/26/accepted PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2013/10/18/medline SP - 384 EP - 90 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 13 IS - 4 N2 - BACKGROUND CONTEXT: Although numerous studies have reported on the loss of flexion-extension range of motion (ROM) associated with laminoplasty, few have reported on the time course of this loss of motion for a long-term follow-up period. PURPOSE: We previously reported our early data on postlaminoplasty cervical ROM. In this article, we describe our minimum 5-year follow-up data to identify the time-dependent change in ROM after cervical laminoplasty. STUDY DESIGN: A prospective cohort study. PATIENT SAMPLE: The procedure was performed in 23 patients. Eighteen patients with a minimum 5-year follow-up were included in the study. OUTCOME MEASURES: The time-dependent neck ROM changes observed in the neutral, flexion, and extension radiographs were used to measure the radiological outcome. The Japanese Orthopaedic Association classification and a numerical rating scale of axial neck pain and arm pain were used to evaluate clinical outcome. METHODS: Twenty-three patients who received unilateral open-door laminoplasties, including miniplate fixation over three levels, were serially evaluated at regular set intervals postoperatively. Eighteen patients with a minimum 5-year follow-up were included in the study. The mean follow-up period was 68.1 months (range, 60-78 months). Nine patients had ossification of posterior longitudinal ligament (OPLL) and nine patients had cervical spondylotic myelopathy (CSM). Enrolled patients were divided into subgroups (OPLL vs. CSM; autofusion vs. nonautofusion) to compare the ROM between the groups. We evaluated the time-dependent neck ROM changes by taking neutral, flexion, and extension radiographs preoperatively and at 1, 3, 6, 9, 12, 18, and 24 months postoperatively. Follow-up radiographs were taken annually after a 2-year follow-up. RESULTS: The preoperative and 1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-month postoperative ROM figures were 39.9 ± 11.2°, 35.0 ± 9.2°, 33.0 ± 11.0°, 30.1 ± 10.4°, 25.8 ± 13.1°, 24.7 ± 10.0°, 23.8 ± 6.5°, 24.6 ± 8.3°, and 23.6 ± 9.4°, respectively, and at the most recent follow-up, ROM was 24.5 ± 10.1°. Thus, the mean ROM decreased by 15.4 ± 8.4° (38.5%) by the last follow-up (p<.0001). In the OPLL group, we observed a more limited cervical ROM than in the CSM group (47.2% vs. 72.7%). As expected, in the laminar autofusion group, the ROM decreased significantly (55.6% decrease), whereas in the nonautofusion group, the ROM decreased less significantly (13.4% decrease) at the last follow-up. Postoperative axial pain did not correlate with the cervical ROM. CONCLUSIONS: These results suggest that the loss of cervical ROM after laminoplasty is time-dependent, and patients with OPLL and laminar autofusion had less ROM. Postlaminoplasty ROM reduction can recover after several years, unless laminar autofusion occurs. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/23218824/Range_of_motion_loss_after_cervical_laminoplasty:_a_prospective_study_with_minimum_5_year_follow_up_data_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(12)01313-7 DB - PRIME DP - Unbound Medicine ER -