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Does preoperative T1 slope affect radiological and functional outcomes after cervical laminoplasty?
Spine (Phila Pa 1976). 2014 Dec 15; 39(26):E1575-81.S

Abstract

STUDY DESIGN

Retrospective comparative study.

OBJECTIVE

To analyze changes in the clinical and radiological factors related to cervical sagittal balance, relative to preoperative T1 slope, in patients with cervical myelopathy after laminoplasty (LP).

SUMMARY OF BACKGROUND DATA

T1 slope is an important factor that should be considered before LP. However, until now, there have been no studies on how preoperative T1 slope affects the sagittal balance of cervical spine and various functional outcomes after LP.

METHODS

Seventy-six patients with cervical myelopathy (M:F ratio = 50:26; mean age = 64.7 ± 9.1 yr) underwent a cervical LP and were followed for more than 2 years. Radiological measurements were performed to analyze the following parameters: (1) C2-C7 sagittal vertical axis; (2) T1 slope; (3) C2-C7 lordosis; and (4) thoracic kyphosis. The visual analogue scale, Japanese Orthopedic Association, neck disability index, and 36-Item Short-Form Health Survey were also investigated. Patients were divided into 2 groups according to preoperative T1 slope, with the cutoff value being the median preoperative T1 slope. Changes in clinical and radiological parameters were compared between the preoperative evaluation and final visit.

RESULTS

Overall, C2-C7 sagittal vertical axis increased from 21.2 to 24.5 mm (P = 0.004) and C2-C7 lordosis decreased from 13.9° to 10.3° (P = 0.007) postoperatively. The T1 slope did not show any postoperative differences. Preoperative C2-C7 lordosis was larger in the high-T1 group (19.1°) than in the low-T1 group (9.0°). However, postoperative changes in C2-C7 sagittal vertical axis and C2-C7 lordosis did not show any between-group differences. Clinical outcomes (except neck pain) demonstrated overall improvement in both groups. Comparing changes in both groups showed no differences in neck pain, arm pain, neck disability index, or 36-Item Short-Form Health Survey physical component score between groups.

CONCLUSION

Cervical sagittal balance is compromised after cervical LP. However, the degree of aggravation does not correlate with the preoperative T1 slope. Most clinical parameters demonstrate overall improvement regardless of preoperative T1 slope.

LEVEL OF EVIDENCE

3.

Authors+Show Affiliations

*Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; and †KS Hospital, Seoul, Korea.No 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

Language

eng

PubMed ID

25271514

Citation

Cho, Jae Hwan, et al. "Does Preoperative T1 Slope Affect Radiological and Functional Outcomes After Cervical Laminoplasty?" Spine, vol. 39, no. 26, 2014, pp. E1575-81.
Cho JH, Ha JK, Kim DG, et al. Does preoperative T1 slope affect radiological and functional outcomes after cervical laminoplasty? Spine (Phila Pa 1976). 2014;39(26):E1575-81.
Cho, J. H., Ha, J. K., Kim, D. G., Song, K. Y., Kim, Y. T., Hwang, C. J., Lee, C. S., & Lee, D. H. (2014). Does preoperative T1 slope affect radiological and functional outcomes after cervical laminoplasty? Spine, 39(26), E1575-81. https://doi.org/10.1097/BRS.0000000000000614
Cho JH, et al. Does Preoperative T1 Slope Affect Radiological and Functional Outcomes After Cervical Laminoplasty. Spine (Phila Pa 1976). 2014 Dec 15;39(26):E1575-81. PubMed PMID: 25271514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does preoperative T1 slope affect radiological and functional outcomes after cervical laminoplasty? AU - Cho,Jae Hwan, AU - Ha,Jung-Ki, AU - Kim,Dae Geun, AU - Song,Keum-Young, AU - Kim,Yung-Tae, AU - Hwang,Chang Ju, AU - Lee,Choon Sung, AU - Lee,Dong-Ho, PY - 2014/10/2/entrez PY - 2014/10/2/pubmed PY - 2015/8/22/medline SP - E1575 EP - 81 JF - Spine JO - Spine (Phila Pa 1976) VL - 39 IS - 26 N2 - STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To analyze changes in the clinical and radiological factors related to cervical sagittal balance, relative to preoperative T1 slope, in patients with cervical myelopathy after laminoplasty (LP). SUMMARY OF BACKGROUND DATA: T1 slope is an important factor that should be considered before LP. However, until now, there have been no studies on how preoperative T1 slope affects the sagittal balance of cervical spine and various functional outcomes after LP. METHODS: Seventy-six patients with cervical myelopathy (M:F ratio = 50:26; mean age = 64.7 ± 9.1 yr) underwent a cervical LP and were followed for more than 2 years. Radiological measurements were performed to analyze the following parameters: (1) C2-C7 sagittal vertical axis; (2) T1 slope; (3) C2-C7 lordosis; and (4) thoracic kyphosis. The visual analogue scale, Japanese Orthopedic Association, neck disability index, and 36-Item Short-Form Health Survey were also investigated. Patients were divided into 2 groups according to preoperative T1 slope, with the cutoff value being the median preoperative T1 slope. Changes in clinical and radiological parameters were compared between the preoperative evaluation and final visit. RESULTS: Overall, C2-C7 sagittal vertical axis increased from 21.2 to 24.5 mm (P = 0.004) and C2-C7 lordosis decreased from 13.9° to 10.3° (P = 0.007) postoperatively. The T1 slope did not show any postoperative differences. Preoperative C2-C7 lordosis was larger in the high-T1 group (19.1°) than in the low-T1 group (9.0°). However, postoperative changes in C2-C7 sagittal vertical axis and C2-C7 lordosis did not show any between-group differences. Clinical outcomes (except neck pain) demonstrated overall improvement in both groups. Comparing changes in both groups showed no differences in neck pain, arm pain, neck disability index, or 36-Item Short-Form Health Survey physical component score between groups. CONCLUSION: Cervical sagittal balance is compromised after cervical LP. However, the degree of aggravation does not correlate with the preoperative T1 slope. Most clinical parameters demonstrate overall improvement regardless of preoperative T1 slope. LEVEL OF EVIDENCE: 3. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/25271514/Does_preoperative_T1_slope_affect_radiological_and_functional_outcomes_after_cervical_laminoplasty L2 - https://doi.org/10.1097/BRS.0000000000000614 DB - PRIME DP - Unbound Medicine ER -