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Factors predicting loss of cervical lordosis following cervical laminoplasty: A critical review.
J Craniovertebr Junction Spine. 2020 Jul-Sep; 11(3):163-168.JC

Abstract

Background

Laminoplasty is a method of posterior cervical decompression which indirectly decompresses the spinal column. Unfortunately, many patients undergoing laminoplasty develops postoperative loss of cervical lordosis (LCL) or kyphotic alignment of cervical spine even though they have sufficient preoperative lordosis which results in poor surgical outcome.

Objective

We would like to highlight the relationship between various radiological parameters of cervical alignment and postoperative LCL in patients undergoing laminoplasty.

Methods

We performed extensive literature search using PubMed, Google Scholar, and Web of Science for relevant articles that report factors affecting cervical alignment following laminoplasty.

Results

On reviewing the literature, patients with high T1 slope have more lordotic alignment of cervical spine preoperatively. They also have more chances of LCL following laminoplasty. C2-C7 sagittal vertical axis (SVA) has no role in predicting LCL following laminoplasty though patients with low T1 slope (≤20°) and high C2-C7 SVA (>22 mm) had correction of kyphotic deformity following laminoplasty. C2-C7 lordosis, Neck Tilt, cervical range of motion, and thoracic kyphosis has no predictive value for LCL. Lower value of T1 slope (T1S-CL) and CL/T1S has more incidence of developing LCL following laminoplasty. The role of C2-C3 disc angle has not yet been evaluated in patients undergoing laminoplasty. Dynamic extension reserve determines the contraction reserve of SPMLC and lower dynamic extension reserve is associated with higher chances of LCL following laminoplasty.

Conclusions

Cervical lordotic alignment is important in maintaining cervical sagittal balance which ultimately is responsible for global spinal sagittal balance and horizontal gaze. Among various radiological parameters, T1 Slope has been reported to be the most important factor affecting cervical alignment following laminoplasty.

Authors+Show Affiliations

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33100764

Citation

Alam, Intekhab, et al. "Factors Predicting Loss of Cervical Lordosis Following Cervical Laminoplasty: a Critical Review." Journal of Craniovertebral Junction & Spine, vol. 11, no. 3, 2020, pp. 163-168.
Alam I, Sharma R, Borkar SA, et al. Factors predicting loss of cervical lordosis following cervical laminoplasty: A critical review. J Craniovertebr Junction Spine. 2020;11(3):163-168.
Alam, I., Sharma, R., Borkar, S. A., Goda, R., Katiyar, V., & Kale, S. S. (2020). Factors predicting loss of cervical lordosis following cervical laminoplasty: A critical review. Journal of Craniovertebral Junction & Spine, 11(3), 163-168. https://doi.org/10.4103/jcvjs.JCVJS_70_20
Alam I, et al. Factors Predicting Loss of Cervical Lordosis Following Cervical Laminoplasty: a Critical Review. J Craniovertebr Junction Spine. 2020 Jul-Sep;11(3):163-168. PubMed PMID: 33100764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors predicting loss of cervical lordosis following cervical laminoplasty: A critical review. AU - Alam,Intekhab, AU - Sharma,Ravi, AU - Borkar,Sachin A, AU - Goda,Revanth, AU - Katiyar,Varidh, AU - Kale,Shashank S, Y1 - 2020/08/14/ PY - 2020/05/20/received PY - 2020/06/26/accepted PY - 2020/10/26/entrez PY - 2020/10/27/pubmed PY - 2020/10/27/medline KW - C2–C3 disc angle KW - C2–C7 Cobb's angle KW - C2–C7 lordosis KW - C2–C7 sagittal vertical axis KW - T1 slope KW - cervical laminoplasty KW - dynamic extension reserve KW - loss of cervical lordosis SP - 163 EP - 168 JF - Journal of craniovertebral junction & spine JO - J Craniovertebr Junction Spine VL - 11 IS - 3 N2 - Background: Laminoplasty is a method of posterior cervical decompression which indirectly decompresses the spinal column. Unfortunately, many patients undergoing laminoplasty develops postoperative loss of cervical lordosis (LCL) or kyphotic alignment of cervical spine even though they have sufficient preoperative lordosis which results in poor surgical outcome. Objective: We would like to highlight the relationship between various radiological parameters of cervical alignment and postoperative LCL in patients undergoing laminoplasty. Methods: We performed extensive literature search using PubMed, Google Scholar, and Web of Science for relevant articles that report factors affecting cervical alignment following laminoplasty. Results: On reviewing the literature, patients with high T1 slope have more lordotic alignment of cervical spine preoperatively. They also have more chances of LCL following laminoplasty. C2-C7 sagittal vertical axis (SVA) has no role in predicting LCL following laminoplasty though patients with low T1 slope (≤20°) and high C2-C7 SVA (>22 mm) had correction of kyphotic deformity following laminoplasty. C2-C7 lordosis, Neck Tilt, cervical range of motion, and thoracic kyphosis has no predictive value for LCL. Lower value of T1 slope (T1S-CL) and CL/T1S has more incidence of developing LCL following laminoplasty. The role of C2-C3 disc angle has not yet been evaluated in patients undergoing laminoplasty. Dynamic extension reserve determines the contraction reserve of SPMLC and lower dynamic extension reserve is associated with higher chances of LCL following laminoplasty. Conclusions: Cervical lordotic alignment is important in maintaining cervical sagittal balance which ultimately is responsible for global spinal sagittal balance and horizontal gaze. Among various radiological parameters, T1 Slope has been reported to be the most important factor affecting cervical alignment following laminoplasty. SN - 0974-8237 UR - https://www.unboundmedicine.com/medline/citation/33100764/Factors_predicting_loss_of_cervical_lordosis_following_cervical_laminoplasty:_A_critical_review_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/33100764/ DB - PRIME DP - Unbound Medicine ER -
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