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Impact of global spine balance and cervical regional alignment on determination of postoperative cervical alignment after laminoplasty.
Medicine (Baltimore). 2018 Nov; 97(45):e13111.M

Abstract

The aim of this study is to analyze the combined impact of preoperative T1 slope (T1S) and C2-C7 sagittal vertical axis (C2-C7 SVA) on determination of cervical alignment after laminoplasty.Forty patients undergoing laminoplasty for cervical spondylotic myelopathy (CSM) with more than 2 years follow-up were enrolled. Three parameters, including cervical lordosis, T1S, and C2-C7 SVA, were measured by preoperative and postoperative radiographs. Receiver operating characteristics (ROC) curve analysis was used to determine the optimal cut-off values of preoperative T1S and C2-C7 SVA for predicting postoperative loss of cervical lordosis. Patients were classified into 4 categories based on cut-off values of preoperative T1S and C2-C7 SVA. The primary outcome was postoperative C2-C7 SVA. Change in radiographic parameters between 4 groups were compared and analyzed.Optimal cut-off values for predicting loss of cervical lordosis were T1S of 20 degrees and C2-C7 SVA of 22 mm. Patients with small C2-C7 SVA, no matter what the value of T1S, got slight loss of cervical lordosis and increase in C2-C7 SVA. Patients with low T1S and large SVA (T1 ≤20° and SVA >22 mm) got postoperative correction of kyphosis and decrease of C2-C7 SVA. However, patients with high T1S and large SVA (T1 >20° and SVA >22 mm) got mean postoperative C2-C7 SVA value of 37.06 mm, close to the threshold value of 40 mm.Determination of cervical alignment after laminoplasty relies on the equilibrium between destruction of cervical structure, kyphotic force, and adaptive compensation of whole spine, lordotic force. Lower T1S means bigger compensatory ability to adjust different severity of cervical sagittal malalignment, and vice versa.

Authors+Show Affiliations

Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.Department of Surgery, Tri-Service General Hospital Songshan Branch.Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.Department of Neurological Surgery, Tri-Service General Hospital.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30407324

Citation

Lin, Bon-Jour, et al. "Impact of Global Spine Balance and Cervical Regional Alignment On Determination of Postoperative Cervical Alignment After Laminoplasty." Medicine, vol. 97, no. 45, 2018, pp. e13111.
Lin BJ, Hong KT, Lin C, et al. Impact of global spine balance and cervical regional alignment on determination of postoperative cervical alignment after laminoplasty. Medicine (Baltimore). 2018;97(45):e13111.
Lin, B. J., Hong, K. T., Lin, C., Chung, T. T., Tang, C. T., Hueng, D. Y., Hsia, C. C., Ju, D. T., Ma, H. I., Liu, M. Y., & Chen, Y. H. (2018). Impact of global spine balance and cervical regional alignment on determination of postoperative cervical alignment after laminoplasty. Medicine, 97(45), e13111. https://doi.org/10.1097/MD.0000000000013111
Lin BJ, et al. Impact of Global Spine Balance and Cervical Regional Alignment On Determination of Postoperative Cervical Alignment After Laminoplasty. Medicine (Baltimore). 2018;97(45):e13111. PubMed PMID: 30407324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of global spine balance and cervical regional alignment on determination of postoperative cervical alignment after laminoplasty. AU - Lin,Bon-Jour, AU - Hong,Kun-Ting, AU - Lin,Chin, AU - Chung,Tzu-Tsao, AU - Tang,Chi-Tun, AU - Hueng,Dueng-Yuan, AU - Hsia,Chung-Ching, AU - Ju,Da-Tong, AU - Ma,Hsin-I, AU - Liu,Ming-Ying, AU - Chen,Yuan-Hao, PY - 2018/11/9/entrez PY - 2018/11/9/pubmed PY - 2018/11/21/medline SP - e13111 EP - e13111 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 45 N2 - The aim of this study is to analyze the combined impact of preoperative T1 slope (T1S) and C2-C7 sagittal vertical axis (C2-C7 SVA) on determination of cervical alignment after laminoplasty.Forty patients undergoing laminoplasty for cervical spondylotic myelopathy (CSM) with more than 2 years follow-up were enrolled. Three parameters, including cervical lordosis, T1S, and C2-C7 SVA, were measured by preoperative and postoperative radiographs. Receiver operating characteristics (ROC) curve analysis was used to determine the optimal cut-off values of preoperative T1S and C2-C7 SVA for predicting postoperative loss of cervical lordosis. Patients were classified into 4 categories based on cut-off values of preoperative T1S and C2-C7 SVA. The primary outcome was postoperative C2-C7 SVA. Change in radiographic parameters between 4 groups were compared and analyzed.Optimal cut-off values for predicting loss of cervical lordosis were T1S of 20 degrees and C2-C7 SVA of 22 mm. Patients with small C2-C7 SVA, no matter what the value of T1S, got slight loss of cervical lordosis and increase in C2-C7 SVA. Patients with low T1S and large SVA (T1 ≤20° and SVA >22 mm) got postoperative correction of kyphosis and decrease of C2-C7 SVA. However, patients with high T1S and large SVA (T1 >20° and SVA >22 mm) got mean postoperative C2-C7 SVA value of 37.06 mm, close to the threshold value of 40 mm.Determination of cervical alignment after laminoplasty relies on the equilibrium between destruction of cervical structure, kyphotic force, and adaptive compensation of whole spine, lordotic force. Lower T1S means bigger compensatory ability to adjust different severity of cervical sagittal malalignment, and vice versa. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/30407324/Impact_of_global_spine_balance_and_cervical_regional_alignment_on_determination_of_postoperative_cervical_alignment_after_laminoplasty_ L2 - http://dx.doi.org/10.1097/MD.0000000000013111 DB - PRIME DP - Unbound Medicine ER -