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Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients with Cervical Spondylotic Myelopathy?
World Neurosurg. 2019 Oct; 130:e687-e693.WN

Abstract

OBJECTIVE

To assess whether preoperative T1 slope and cervical lordosis mismatching affect the surgical outcomes of patients with cervical spondylotic myelopathy (CSM) after laminoplasty.

METHODS

A total of 85 patients with CSM who underwent unilateral open-door laminoplasty between January 2013 and May 2017 were retrospectively reviewed. Based on preoperative T1 slope and C2-C7 lordosis matching, the patients were divided into 2 groups: the match group and the mismatch group. The T1 slope minus C2-C7 lordosis (T1S-CL) <20° was defined as matching. Radiographic parameters included T1 slope, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), and T1S-CL. Clinical outcomes were based on the Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores.

RESULTS

The preoperative T1S-CL had significant correlation with T1 slope (r = 0.283), C2-C7 lordosis (r = -0.611), and C2-C7 SVA (r = 0.331). At the final follow-up, patients in the mismatch group had a higher incidence of postoperative cervical kyphosis (P = 0.007) and C2-C7 SVA >40 mm (P = 0.043). The mismatch group also had greater △C2-C7 lordosis (P = 0.028), △C2-C7 SVA (P = 0.042), and △T1S-CL (P = 0.044). Comparison of clinical outcomes revealed that patients in the match group had better NDI and JOA recovery (P < 0.05).

CONCLUSIONS

T1S-CL is a clinically relevant parameter for surgical decision making because patients with T1S-CL mismatching are more likely to have postoperative kyphotic alignment changes and cervical sagittal imbalance. Laminoplasty might not be a suitable option for patients with T1S-CL mismatching.

Authors+Show Affiliations

Department of Spine Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.Orthopedics Department, Fuzhou Second Hospital, Xiamen University; Fuzhou, Fujian, People's Republic of China.Department of Spine Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.Department of Spine Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.Department of Spine Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.Department of Spine Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China. Electronic address: xwhfygk@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31279919

Citation

Rao, Hongming, et al. "Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients With Cervical Spondylotic Myelopathy?" World Neurosurgery, vol. 130, 2019, pp. e687-e693.
Rao H, Huang Y, Lan Z, et al. Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients with Cervical Spondylotic Myelopathy? World Neurosurg. 2019;130:e687-e693.
Rao, H., Huang, Y., Lan, Z., Xu, Z., Li, G., & Xu, W. (2019). Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients with Cervical Spondylotic Myelopathy? World Neurosurgery, 130, e687-e693. https://doi.org/10.1016/j.wneu.2019.06.193
Rao H, et al. Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients With Cervical Spondylotic Myelopathy. World Neurosurg. 2019;130:e687-e693. PubMed PMID: 31279919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does Preoperative T1 Slope and Cervical Lordosis Mismatching Affect Surgical Outcomes After Laminoplasty in Patients with Cervical Spondylotic Myelopathy? AU - Rao,Hongming, AU - Huang,Yuming, AU - Lan,Zhibin, AU - Xu,Zhengquan, AU - Li,Guishuang, AU - Xu,Weihong, Y1 - 2019/07/04/ PY - 2019/03/04/received PY - 2019/06/24/revised PY - 2019/06/25/accepted PY - 2019/7/8/pubmed PY - 2020/1/22/medline PY - 2019/7/8/entrez KW - C2–C7 lordosis KW - Cervical spondylotic myelopathy KW - Kyphotic alignment change KW - Laminoplasty KW - Sagittal alignment KW - T1 slope SP - e687 EP - e693 JF - World neurosurgery JO - World Neurosurg VL - 130 N2 - OBJECTIVE: To assess whether preoperative T1 slope and cervical lordosis mismatching affect the surgical outcomes of patients with cervical spondylotic myelopathy (CSM) after laminoplasty. METHODS: A total of 85 patients with CSM who underwent unilateral open-door laminoplasty between January 2013 and May 2017 were retrospectively reviewed. Based on preoperative T1 slope and C2-C7 lordosis matching, the patients were divided into 2 groups: the match group and the mismatch group. The T1 slope minus C2-C7 lordosis (T1S-CL) <20° was defined as matching. Radiographic parameters included T1 slope, C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), and T1S-CL. Clinical outcomes were based on the Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores. RESULTS: The preoperative T1S-CL had significant correlation with T1 slope (r = 0.283), C2-C7 lordosis (r = -0.611), and C2-C7 SVA (r = 0.331). At the final follow-up, patients in the mismatch group had a higher incidence of postoperative cervical kyphosis (P = 0.007) and C2-C7 SVA >40 mm (P = 0.043). The mismatch group also had greater △C2-C7 lordosis (P = 0.028), △C2-C7 SVA (P = 0.042), and △T1S-CL (P = 0.044). Comparison of clinical outcomes revealed that patients in the match group had better NDI and JOA recovery (P < 0.05). CONCLUSIONS: T1S-CL is a clinically relevant parameter for surgical decision making because patients with T1S-CL mismatching are more likely to have postoperative kyphotic alignment changes and cervical sagittal imbalance. Laminoplasty might not be a suitable option for patients with T1S-CL mismatching. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31279919/Does_Preoperative_T1_Slope_and_Cervical_Lordosis_Mismatching_Affect_Surgical_Outcomes_After_Laminoplasty_in_Patients_with_Cervical_Spondylotic_Myelopathy L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)31850-9 DB - PRIME DP - Unbound Medicine ER -