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Correlation between cervical spine sagittal alignment and clinical outcome after cervical laminoplasty for ossification of the posterior longitudinal ligament

Authors
 Chang Kyu Lee  ;  Dong Ah Shin  ;  Seong Yi  ;  Keung Nyun Kim  ;  Hyun Chul Shin  ;  Do Heum Yoon  ;  Yoon Ha 
Citation
 Journal of Neurosurgery - Spine, Vol.24(1) : 100-107, 2016 
Journal Title
 Journal of Neurosurgery - Spine 
ISSN
 1547-5654 
Issue Date
2016
MeSH
Adult ; Aged ; Cervical Vertebrae/surgery* ; Female ; Humans ; Laminoplasty*/methods ; Longitudinal Ligaments/surgery* ; Lordosis/surgery* ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament/surgery* ; Spinal Fusion/methods ; Treatment Outcome
Keywords
ACDF = anterior cervical discectomy and fusion ; CSM = cervical spondylotic myelopathy ; HRQOL = health-related quality of life ; JOA = Japanese Orthopaedic Association ; NDI = Neck Disability Index ; OPLL = ossification of the posterior longitudinal ligament ; SF-36 = 36-Item Short-Form Health Survey ; SVA = sagittal vertical axis ; VAS = visual analog scale ; cervical laminoplasty ; cervical ossification of the posterior longitudinal ligament ; cervical spine sagittal alignment ; clinical outcome
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. KEYWORDS: ACDF = anterior cervical discectomy and fusion; CSM = cervical spondylotic myelopathy; HRQOL = health-related quality of life; JOA = Japanese Orthopaedic Association; NDI = Neck Disability Index; OPLL = ossification of the posterior longitudinal ligament; SF-36 = 36-Item Short-Form Health Survey; SVA = sagittal vertical axis; VAS = visual analog scale; cervical laminoplasty; cervical ossification of the posterior longitudinal ligament; cervical spine sagittal alignment; clinical outcome
Full Text
http://thejns.org/doi/abs/10.3171/2015.4.SPINE141004
DOI
10.3171/2015.4.SPINE141004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
김긍년(Kim, Keung Nyun)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
이성(Yi, Seong)
이창규(Lee, Chang Kyu)
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152513
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