Differences in Postoperative Changes of Cervical Sagittal Alignment and Balance After Laminoplasty Between Cervical Spondylotic Myelopathy and Cervical Ossification of the Posterior Longitudinal Ligament
| Autor: | Akira Yamagishi, Atsunori Ohnishi, Tetsuo Ohwada, Hironobu Sakaura |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Orthodontics
030222 orthopedics cervical spondylotic myelopathy business.industry medicine.medical_treatment Sagittal balance Ossification of the posterior longitudinal ligament Retrospective cohort study Original Articles Laminoplasty 03 medical and health sciences 0302 clinical medicine ossification of the posterior longitudinal ligament Spondylotic myelopathy medicine cervical sagittal balance Sagittal alignment laminoplasty Orthopedics and Sports Medicine Surgery Neurology (clinical) business 030217 neurology & neurosurgery cervical sagittal alignment Balance (ability) |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5682 |
| Popis: | Study Design: Retrospective cohort study. Objectives: To compare postoperative changes of cervical sagittal alignment (CSA) and cervical sagittal balance (CSB) after laminoplasty between cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) and to examine impacts of these radiologic changes on neurologic outcomes. Methods: A total of 168 consecutive patients with CSM (CSM group) and 51 consecutive patients with OPLL (OPLL group) were included. As indicators of CSA and CSB, the C2-7 angle and C1-C7 sagittal vertical axis (SVA) were, respectively, measured before surgery and at 2-year follow-up. Neurologic status was assessed using the Japanese Orthopaedic Association score before surgery and at 2-year follow-up. Results: Whereas both postoperative loss of C2-7 angle and increase of C1-C7 SVA were significantly greater in the elderly subgroup of the CSM group, patient age did not significantly affect these changes in the OPLL group. Preservation of C7 maintained C1-C7 SVA at postoperative 2 years only in the CSM group. Postoperative cervical kyphosis and sagittal imbalance significantly decreased neurologic improvement in the CSM group but not in the OPLL group. Conclusions: Elderly patients with CSM have significantly greater postoperative loss of lordosis and increase in C1-C7 SVA than nonelderly patients, and both postoperative kyphotic deformity and sagittal imbalance significantly deteriorate neurologic recovery. On the other hand, although patients with OPLL, irrespective of patient age and preservation of C7, have significantly more loss of lordosis and increase in C1-C7 SVA than CSM patients, neither postoperative kyphotic deformity nor sagittal imbalance significantly deteriorates neurologic recovery in OPLL patients. |
| Databáze: | OpenAIRE |
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