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Modified K-line in magnetic resonance imaging predicts clinical outcome in patients with nonlordotic alignment after laminoplasty for cervical spondylotic myelopathy.
Spine (Phila Pa 1976). 2014 Oct 01; 39(21):E1261-8.S

Abstract

STUDY DESIGN

Retrospective single-center study.

OBJECTIVE

To investigate whether a preoperative index predicts clinical outcome after laminoplasty for cervical spondylotic myelopathy.

SUMMARY OF BACKGROUND DATA

This is the first study using the modified K-line, which connects the midpoints of the spinal cord at the C2 and C7 levels on midsagittal magnetic resonance imaging, to assess the relationship between postoperative clinical outcome and anticipated degree of spinal cord shifting.

METHODS

Sixty-one consecutive patients who underwent laminoplasty for the treatment of cervical spondylotic myelopathy between 2000 and 2011 at our hospital were retrospectively reviewed. The interval between the preoperative mK-line and the anterior structure of the spinal canal at each segment of the C3 to C6 levels (INTn, n = 3-6) were measured on sagittal T1-weighted magnetic resonance imaging, and the sum of the INTn (INTsum) was then calculated. The degree of posterior cord shift was defined as follows: %Csum = ΣCn; Cn = (Bn-An) × 100/An (n = 3-6; An and Bn represent the preoperative and postoperative intervals between the midpoint of the spinal cord and the anterior impingement at each segment on sagittal T1-weighted magnetic resonance imaging, respectively). In addition, we defined INTmin as the minimum interval of the INTn in each patient. All patients were divided into lordotic and nonlordotic groups on the basis of lateral neutral radiography. The Japanese Orthopaedic Association (JOA) scoring system and recovery rate of the JOA score for cervical myelopathy was evaluated as clinical outcomes.

RESULTS

The recovery rate of the JOA score was 48.1%. The lordotic and nonlordotic groups contained 38 and 23 patients, respectively. Linear regression analysis revealed that INTmin was significantly correlated with the recovery rate of the patients in the nonlordotic group, whereas INTsum was not associated with recovery of the JOA score.

CONCLUSION

We identified INTmin as a predictive factor for clinical outcomes in patients with nonlordotic alignment after laminoplasty.

LEVEL OF EVIDENCE

4.

Authors+Show Affiliations

*Department of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan †Section of Regenerative Therapeutics for Spine and Spinal Cord, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan ‡Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA; and §Global Center of Excellence (GCOE) Program for International Research Center for Molecular Science in Tooth and Bone Disease, Tokyo Medical and Dental University, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

25077905

Citation

Taniyama, Takashi, et al. "Modified K-line in Magnetic Resonance Imaging Predicts Clinical Outcome in Patients With Nonlordotic Alignment After Laminoplasty for Cervical Spondylotic Myelopathy." Spine, vol. 39, no. 21, 2014, pp. E1261-8.
Taniyama T, Hirai T, Yoshii T, et al. Modified K-line in magnetic resonance imaging predicts clinical outcome in patients with nonlordotic alignment after laminoplasty for cervical spondylotic myelopathy. Spine. 2014;39(21):E1261-8.
Taniyama, T., Hirai, T., Yoshii, T., Yamada, T., Yasuda, H., Saito, M., Inose, H., Kato, T., Kawabata, S., & Okawa, A. (2014). Modified K-line in magnetic resonance imaging predicts clinical outcome in patients with nonlordotic alignment after laminoplasty for cervical spondylotic myelopathy. Spine, 39(21), E1261-8. https://doi.org/10.1097/BRS.0000000000000531
Taniyama T, et al. Modified K-line in Magnetic Resonance Imaging Predicts Clinical Outcome in Patients With Nonlordotic Alignment After Laminoplasty for Cervical Spondylotic Myelopathy. Spine. 2014 Oct 1;39(21):E1261-8. PubMed PMID: 25077905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified K-line in magnetic resonance imaging predicts clinical outcome in patients with nonlordotic alignment after laminoplasty for cervical spondylotic myelopathy. AU - Taniyama,Takashi, AU - Hirai,Takashi, AU - Yoshii,Toshitaka, AU - Yamada,Tsuyoshi, AU - Yasuda,Hiroaki, AU - Saito,Masanori, AU - Inose,Hiroyuki, AU - Kato,Tsuyoshi, AU - Kawabata,Shigenori, AU - Okawa,Atsushi, PY - 2014/8/1/entrez PY - 2014/8/1/pubmed PY - 2015/10/9/medline SP - E1261 EP - 8 JF - Spine JO - Spine VL - 39 IS - 21 N2 - STUDY DESIGN: Retrospective single-center study. OBJECTIVE: To investigate whether a preoperative index predicts clinical outcome after laminoplasty for cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA: This is the first study using the modified K-line, which connects the midpoints of the spinal cord at the C2 and C7 levels on midsagittal magnetic resonance imaging, to assess the relationship between postoperative clinical outcome and anticipated degree of spinal cord shifting. METHODS: Sixty-one consecutive patients who underwent laminoplasty for the treatment of cervical spondylotic myelopathy between 2000 and 2011 at our hospital were retrospectively reviewed. The interval between the preoperative mK-line and the anterior structure of the spinal canal at each segment of the C3 to C6 levels (INTn, n = 3-6) were measured on sagittal T1-weighted magnetic resonance imaging, and the sum of the INTn (INTsum) was then calculated. The degree of posterior cord shift was defined as follows: %Csum = ΣCn; Cn = (Bn-An) × 100/An (n = 3-6; An and Bn represent the preoperative and postoperative intervals between the midpoint of the spinal cord and the anterior impingement at each segment on sagittal T1-weighted magnetic resonance imaging, respectively). In addition, we defined INTmin as the minimum interval of the INTn in each patient. All patients were divided into lordotic and nonlordotic groups on the basis of lateral neutral radiography. The Japanese Orthopaedic Association (JOA) scoring system and recovery rate of the JOA score for cervical myelopathy was evaluated as clinical outcomes. RESULTS: The recovery rate of the JOA score was 48.1%. The lordotic and nonlordotic groups contained 38 and 23 patients, respectively. Linear regression analysis revealed that INTmin was significantly correlated with the recovery rate of the patients in the nonlordotic group, whereas INTsum was not associated with recovery of the JOA score. CONCLUSION: We identified INTmin as a predictive factor for clinical outcomes in patients with nonlordotic alignment after laminoplasty. LEVEL OF EVIDENCE: 4. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/25077905/Modified_K_line_in_magnetic_resonance_imaging_predicts_clinical_outcome_in_patients_with_nonlordotic_alignment_after_laminoplasty_for_cervical_spondylotic_myelopathy_ L2 - http://dx.doi.org/10.1097/BRS.0000000000000531 DB - PRIME DP - Unbound Medicine ER -