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Correlation between cervical spine sagittal alignment and clinical outcome after cervical laminoplasty for ossification of the posterior longitudinal ligament.
J Neurosurg Spine. 2016 Jan; 24(1):100-7.JN

Abstract

OBJECTIVE

The goal of this study was to determine the relationship between cervical spine sagittal alignment and clinical outcomes after cervical laminoplasty in patients with ossification of the posterior longitudinal ligament (OPLL).

METHODS

Fifty consecutive patients who underwent a cervical laminoplasty for OPLL between January 2012 and January 2013 and who were followed up for at least 1 year were analyzed in this study. Standing plain radiographs of the cervical spine, CT (midsagittal view), and MRI (T2-weighted sagittal view) were obtained (anteroposterior, lateral, flexion, and extension) pre- and postoperatively. Cervical spine alignment was assessed with the following 3 parameters: the C2-7 Cobb angle, C2-7 sagittal vertical axis (SVA), and T-1 slope minus C2-7 Cobb angle. The change in cervical sagittal alignment was defined as the difference between the post- and preoperative C2-7 Cobb angles, C2-7 SVAs, and T-1 slope minus C2-7 Cobb angles. Outcome assessments (visual analog scale [VAS], Oswestry Neck Disability Index [NDI], 36-Item Short-Form Health Survey [SF-36], and Japanese Orthopaedic Association [JOA] scores) were obtained in all patients pre- and postoperatively.

RESULTS

The average patient age was 56.3 years (range 38-72 years). There were 34 male patients and 16 female patients. Cervical laminoplasty for OPLL helped alleviate radiculomyelopathy. Compared with the preoperative scores, improvement was seen in postoperative VAS and JOA scores. After laminoplasty, 35 patients had kyphotic changes, and 15 had lordotic changes. However, cervical sagittal alignment after laminoplasty was not significantly associated with clinical outcomes in terms of postoperative improvement of the JOA score (C2-7 Cobb angle: p = 0.633; C2-7 SVA: p = 0.817; T-1 slope minus C2-7 lordosis: p = 0.554), the SF-36 score (C2-7 Cobb angle: p = 0.554; C2-7 SVA: p = 0.793; T-1 slope minus C2-7 lordosis: p = 0.829), the VAS neck score (C2-7 Cobb angle: p = 0.263; C2-7 SVA: p = 0.716; T-1 slope minus C2-7 lordosis: p = 0.497), or the NDI score (C2-7 Cobb angle: p = 0.568; C2-7 SVA: p = 0.279; T-1 slope minus C2-7 lordosis: p = 0.966). Similarly, the change in cervical sagittal alignment was not related to the JOA (p = 0.604), SF-36 (p = 0.308), VAS neck (p = 0.832), or NDI (p = 0.608) scores.

CONCLUSIONS

Cervical laminoplasty for OPLL improved radiculomyelopathy. Cervical laminoplasty increased the probability of cervical kyphotic alignment. However, cervical sagittal alignment and clinical outcomes were not clearly related.

Authors+Show Affiliations

Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine; and.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26431070

Citation

Lee, Chang Kyu, et al. "Correlation Between Cervical Spine Sagittal Alignment and Clinical Outcome After Cervical Laminoplasty for Ossification of the Posterior Longitudinal Ligament." Journal of Neurosurgery. Spine, vol. 24, no. 1, 2016, pp. 100-7.
Lee CK, Shin DA, Yi S, et al. Correlation between cervical spine sagittal alignment and clinical outcome after cervical laminoplasty for ossification of the posterior longitudinal ligament. J Neurosurg Spine. 2016;24(1):100-7.
Lee, C. K., Shin, D. A., Yi, S., Kim, K. N., Shin, H. C., Yoon, D. H., & Ha, Y. (2016). Correlation between cervical spine sagittal alignment and clinical outcome after cervical laminoplasty for ossification of the posterior longitudinal ligament. Journal of Neurosurgery. Spine, 24(1), 100-7. https://doi.org/10.3171/2015.4.SPINE141004
Lee CK, et al. Correlation Between Cervical Spine Sagittal Alignment and Clinical Outcome After Cervical Laminoplasty for Ossification of the Posterior Longitudinal Ligament. J Neurosurg Spine. 2016;24(1):100-7. PubMed PMID: 26431070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between cervical spine sagittal alignment and clinical outcome after cervical laminoplasty for ossification of the posterior longitudinal ligament. AU - Lee,Chang Kyu, AU - Shin,Dong Ah, AU - Yi,Seong, AU - Kim,Keung Nyun, AU - Shin,Hyun Chul, AU - Yoon,Do Heum, AU - Ha,Yoon, Y1 - 2015/10/02/ PY - 2015/10/3/entrez PY - 2015/10/3/pubmed PY - 2016/5/18/medline KW - ACDF = anterior cervical discectomy and fusion KW - CSM = cervical spondylotic myelopathy KW - HRQOL = health-related quality of life KW - JOA = Japanese Orthopaedic Association KW - NDI = Neck Disability Index KW - OPLL = ossification of the posterior longitudinal ligament KW - SF-36 = 36-Item Short-Form Health Survey KW - SVA = sagittal vertical axis KW - VAS = visual analog scale KW - cervical laminoplasty KW - cervical ossification of the posterior longitudinal ligament KW - cervical spine sagittal alignment KW - clinical outcome SP - 100 EP - 7 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 24 IS - 1 N2 - OBJECTIVE: The goal of this study was to determine the relationship between cervical spine sagittal alignment and clinical outcomes after cervical laminoplasty in patients with ossification of the posterior longitudinal ligament (OPLL). METHODS: Fifty consecutive patients who underwent a cervical laminoplasty for OPLL between January 2012 and January 2013 and who were followed up for at least 1 year were analyzed in this study. Standing plain radiographs of the cervical spine, CT (midsagittal view), and MRI (T2-weighted sagittal view) were obtained (anteroposterior, lateral, flexion, and extension) pre- and postoperatively. Cervical spine alignment was assessed with the following 3 parameters: the C2-7 Cobb angle, C2-7 sagittal vertical axis (SVA), and T-1 slope minus C2-7 Cobb angle. The change in cervical sagittal alignment was defined as the difference between the post- and preoperative C2-7 Cobb angles, C2-7 SVAs, and T-1 slope minus C2-7 Cobb angles. Outcome assessments (visual analog scale [VAS], Oswestry Neck Disability Index [NDI], 36-Item Short-Form Health Survey [SF-36], and Japanese Orthopaedic Association [JOA] scores) were obtained in all patients pre- and postoperatively. RESULTS: The average patient age was 56.3 years (range 38-72 years). There were 34 male patients and 16 female patients. Cervical laminoplasty for OPLL helped alleviate radiculomyelopathy. Compared with the preoperative scores, improvement was seen in postoperative VAS and JOA scores. After laminoplasty, 35 patients had kyphotic changes, and 15 had lordotic changes. However, cervical sagittal alignment after laminoplasty was not significantly associated with clinical outcomes in terms of postoperative improvement of the JOA score (C2-7 Cobb angle: p = 0.633; C2-7 SVA: p = 0.817; T-1 slope minus C2-7 lordosis: p = 0.554), the SF-36 score (C2-7 Cobb angle: p = 0.554; C2-7 SVA: p = 0.793; T-1 slope minus C2-7 lordosis: p = 0.829), the VAS neck score (C2-7 Cobb angle: p = 0.263; C2-7 SVA: p = 0.716; T-1 slope minus C2-7 lordosis: p = 0.497), or the NDI score (C2-7 Cobb angle: p = 0.568; C2-7 SVA: p = 0.279; T-1 slope minus C2-7 lordosis: p = 0.966). Similarly, the change in cervical sagittal alignment was not related to the JOA (p = 0.604), SF-36 (p = 0.308), VAS neck (p = 0.832), or NDI (p = 0.608) scores. CONCLUSIONS: Cervical laminoplasty for OPLL improved radiculomyelopathy. Cervical laminoplasty increased the probability of cervical kyphotic alignment. However, cervical sagittal alignment and clinical outcomes were not clearly related. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/26431070/Correlation_between_cervical_spine_sagittal_alignment_and_clinical_outcome_after_cervical_laminoplasty_for_ossification_of_the_posterior_longitudinal_ligament_ L2 - https://thejns.org/doi/10.3171/2015.4.SPINE141004 DB - PRIME DP - Unbound Medicine ER -