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T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy.
Spine (Phila Pa 1976). 2013 Jul 15; 38(16):E992-7.S

Abstract

STUDY DESIGN

Prospective study.

OBJECTIVE

To analyze the effect of T1 slope on kyphotic alignment change after cervical laminoplasty in patients with cervical myelopathy.

SUMMARY OF BACKGROUND DATA

Laminoplasty is a posterior method, and maintenance of both preoperative and postoperative lordotic alignment is prerequisite for the successful surgery. Unfortunately, patients who underwent laminoplasty tend to have kyphotic alignment change after operation despite sufficient preoperative lordosis, and such kyphotic alignment change after cervical laminoplasty can reduce surgical outcome and require additional surgery.

METHODS

Consecutive patients who underwent cervical laminoplasty for cervical myelopathy were enrolled. Cervical spine lateral radiography in neutral, flexion, and extension were taken before surgery and at 2-year follow-up. Patients were divided into 2 groups according to the preoperative T1 slope, and postoperative cervical alignment change was compared according to the preoperative T1 slope.

RESULTS

A total of 51 patients were enrolled in this study. The mean age was 57.2 years (range, 39-88 yr). There were 39 male patients and 12 female patients. There were no differences in age, sex, the presence and type of ossification of posterior longitudinal ligament, and operation level between the patients with higher and lower preoperative T1 slope. Patients with higher preoperative T1 slope had more lordotic preoperative cervical alignment; however, they had more kyphotic alignment changes after laminoplasty (P < 0.001). After univariate logistic regression, only higher preoperative T1 slope was associated with significantly increased odds ratio for postoperative kyphotic alignment changes.

CONCLUSION

We hypothesized that kyphotic alignment change by posterior structural injury after cervical laminoplasty would be more marked in patients with high T1 slope, and demonstrated that patients with cervical myelopathy with high T1 slope had more kyphotic alignment changes after cervical laminoplasty at 2-year follow-up.

Authors+Show Affiliations

Spine Center, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23609205

Citation

Kim, Tae-Hwan, et al. "T1 Slope as a Predictor of Kyphotic Alignment Change After Laminoplasty in Patients With Cervical Myelopathy." Spine, vol. 38, no. 16, 2013, pp. E992-7.
Kim TH, Lee SY, Kim YC, et al. T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy. Spine. 2013;38(16):E992-7.
Kim, T. H., Lee, S. Y., Kim, Y. C., Park, M. S., & Kim, S. W. (2013). T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy. Spine, 38(16), E992-7. https://doi.org/10.1097/BRS.0b013e3182972e1b
Kim TH, et al. T1 Slope as a Predictor of Kyphotic Alignment Change After Laminoplasty in Patients With Cervical Myelopathy. Spine. 2013 Jul 15;38(16):E992-7. PubMed PMID: 23609205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy. AU - Kim,Tae-Hwan, AU - Lee,Seung Yeop, AU - Kim,Yong Chan, AU - Park,Moon Soo, AU - Kim,Seok Woo, PY - 2013/4/24/entrez PY - 2013/4/24/pubmed PY - 2014/2/11/medline SP - E992 EP - 7 JF - Spine JO - Spine VL - 38 IS - 16 N2 - STUDY DESIGN: Prospective study. OBJECTIVE: To analyze the effect of T1 slope on kyphotic alignment change after cervical laminoplasty in patients with cervical myelopathy. SUMMARY OF BACKGROUND DATA: Laminoplasty is a posterior method, and maintenance of both preoperative and postoperative lordotic alignment is prerequisite for the successful surgery. Unfortunately, patients who underwent laminoplasty tend to have kyphotic alignment change after operation despite sufficient preoperative lordosis, and such kyphotic alignment change after cervical laminoplasty can reduce surgical outcome and require additional surgery. METHODS: Consecutive patients who underwent cervical laminoplasty for cervical myelopathy were enrolled. Cervical spine lateral radiography in neutral, flexion, and extension were taken before surgery and at 2-year follow-up. Patients were divided into 2 groups according to the preoperative T1 slope, and postoperative cervical alignment change was compared according to the preoperative T1 slope. RESULTS: A total of 51 patients were enrolled in this study. The mean age was 57.2 years (range, 39-88 yr). There were 39 male patients and 12 female patients. There were no differences in age, sex, the presence and type of ossification of posterior longitudinal ligament, and operation level between the patients with higher and lower preoperative T1 slope. Patients with higher preoperative T1 slope had more lordotic preoperative cervical alignment; however, they had more kyphotic alignment changes after laminoplasty (P < 0.001). After univariate logistic regression, only higher preoperative T1 slope was associated with significantly increased odds ratio for postoperative kyphotic alignment changes. CONCLUSION: We hypothesized that kyphotic alignment change by posterior structural injury after cervical laminoplasty would be more marked in patients with high T1 slope, and demonstrated that patients with cervical myelopathy with high T1 slope had more kyphotic alignment changes after cervical laminoplasty at 2-year follow-up. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/23609205/T1_slope_as_a_predictor_of_kyphotic_alignment_change_after_laminoplasty_in_patients_with_cervical_myelopathy_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3182972e1b DB - PRIME DP - Unbound Medicine ER -