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Relationship of T1 slope with loss of lordosis and surgical outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament.
Clin Neurol Neurosurg. 2018 01; 164:19-24.CN

Abstract

OBJECTIVE

T1 slope (T1S) has emerged as a predictor of kyphotic alignment change after laminoplasty. Although it was reported that patients with cervical ossification of the posterior longitudinal ligament (OPLL) and higher T1S had more pronounced lordotic curvature before surgery and higher loss of cervical lordosis after surgery, few studies have attempted to correlate these findings with clinical outcomes. We aimed to investigate the relationship of T1S with loss of cervical lordosis and surgical outcomes after laminoplasty for cervical OPLL.

PATIENTS AND METHODS

35 consecutive patients (26 men and 9 women) with cervical OPLL who underwent double-door laminoplasty were followed for more than 12 months. Radiological and clinical measurements were performed to analyze the following parameters: pre and postoperative C2-C7 Cobb lordotic angle (LA), preoperative C2-C7 range of motion (ROM), loss of cervical lordosis, percentage of change in postoperative kyphosis, pre and postoperative C2-C7 sagittal vertical axis (SVA), change in C2-C7 SVA and occupying ratio of the OPLL, Japanese Orthopedic Association (JOA) score recovery rate, preoperative MRI grade.

RESULTS

Patients were divided into 2 groups according to preoperative T1 slope, with the cutoff value being the average preoperative T1 slope. Preoperative C2-C7 Cobb LA (P=0.007) and loss of cervical lordosis (P=0.034) differed between the two groups. Preoperative C2-C7 Cobb LA (R=0.50, P=0.002) and loss of cervical lordosis (R=0.36, P=0.036) were significantly correlated to preoperative T1S. Multivariate linear regression analysis showed that the preoperative T1S was not related to JOA score recovery rate and the preoperative MRI grade (OR=-9.985, P=0.015) was only related to JOA score recovery rate.

CONCLUSION

Although the degree of alignment compromise is correlated with the preoperative T1S, clinical outcomes demonstrate overall improvement after cervical laminoplasty with cervical OPLL, regardless of preoperative T1S.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan. Electronic address: masashim@oita-u.ac.jp.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29145042

Citation

Miyazaki, Masashi, et al. "Relationship of T1 Slope With Loss of Lordosis and Surgical Outcomes After Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament." Clinical Neurology and Neurosurgery, vol. 164, 2018, pp. 19-24.
Miyazaki M, Ishihara T, Notani N, et al. Relationship of T1 slope with loss of lordosis and surgical outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament. Clin Neurol Neurosurg. 2018;164:19-24.
Miyazaki, M., Ishihara, T., Notani, N., Kanezaki, S., & Tsumura, H. (2018). Relationship of T1 slope with loss of lordosis and surgical outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament. Clinical Neurology and Neurosurgery, 164, 19-24. https://doi.org/10.1016/j.clineuro.2017.11.007
Miyazaki M, et al. Relationship of T1 Slope With Loss of Lordosis and Surgical Outcomes After Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament. Clin Neurol Neurosurg. 2018;164:19-24. PubMed PMID: 29145042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of T1 slope with loss of lordosis and surgical outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament. AU - Miyazaki,Masashi, AU - Ishihara,Toshinobu, AU - Notani,Naoki, AU - Kanezaki,Shozo, AU - Tsumura,Hiroshi, Y1 - 2017/11/13/ PY - 2017/09/08/received PY - 2017/10/30/revised PY - 2017/11/11/accepted PY - 2017/11/18/pubmed PY - 2019/1/15/medline PY - 2017/11/18/entrez KW - JOA score KW - MRI KW - SVA KW - T1 slope KW - cervical laminoplasty KW - cervical ossification of the posterior longitudinal ligament KW - clinical outcome KW - intramedullary high intensity change KW - loss of lordosis SP - 19 EP - 24 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 164 N2 - OBJECTIVE: T1 slope (T1S) has emerged as a predictor of kyphotic alignment change after laminoplasty. Although it was reported that patients with cervical ossification of the posterior longitudinal ligament (OPLL) and higher T1S had more pronounced lordotic curvature before surgery and higher loss of cervical lordosis after surgery, few studies have attempted to correlate these findings with clinical outcomes. We aimed to investigate the relationship of T1S with loss of cervical lordosis and surgical outcomes after laminoplasty for cervical OPLL. PATIENTS AND METHODS: 35 consecutive patients (26 men and 9 women) with cervical OPLL who underwent double-door laminoplasty were followed for more than 12 months. Radiological and clinical measurements were performed to analyze the following parameters: pre and postoperative C2-C7 Cobb lordotic angle (LA), preoperative C2-C7 range of motion (ROM), loss of cervical lordosis, percentage of change in postoperative kyphosis, pre and postoperative C2-C7 sagittal vertical axis (SVA), change in C2-C7 SVA and occupying ratio of the OPLL, Japanese Orthopedic Association (JOA) score recovery rate, preoperative MRI grade. RESULTS: Patients were divided into 2 groups according to preoperative T1 slope, with the cutoff value being the average preoperative T1 slope. Preoperative C2-C7 Cobb LA (P=0.007) and loss of cervical lordosis (P=0.034) differed between the two groups. Preoperative C2-C7 Cobb LA (R=0.50, P=0.002) and loss of cervical lordosis (R=0.36, P=0.036) were significantly correlated to preoperative T1S. Multivariate linear regression analysis showed that the preoperative T1S was not related to JOA score recovery rate and the preoperative MRI grade (OR=-9.985, P=0.015) was only related to JOA score recovery rate. CONCLUSION: Although the degree of alignment compromise is correlated with the preoperative T1S, clinical outcomes demonstrate overall improvement after cervical laminoplasty with cervical OPLL, regardless of preoperative T1S. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/29145042/Relationship_of_T1_slope_with_loss_of_lordosis_and_surgical_outcomes_after_laminoplasty_for_cervical_ossification_of_the_posterior_longitudinal_ligament_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(17)30323-2 DB - PRIME DP - Unbound Medicine ER -