Which Factors Affect Postoperative Cervical Kyphosis after Laminoplasty for Cervical Spondylotic Myelopathy?

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  • 頚椎症性脊髄症に対する椎弓形成術後後弯進行の臨床的意義と術前危険因子

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Abstract

<p>Introduction: We assessed which factors affected postoperative cervical kyphosis after laminoplasty for cervical spondylotic myelopathy (CSM).</p><p>Methods: We retrospectively recruited 57 cases that underwent laminoplasty for CSM and were followed-up for at least 2 years after operation. Regarding clinical outcomes, we assessed the Japanese Orthopaedic Association (JOA) recovery rate of these individuals.</p><p>Results: In these 57 cases, 11 cases (19.3%) was found to be kyphotic (ΔC2-7 Cobb angle > 5°) at neutral position in the 2 years after operation (Group K, the others were Group L). Their statistical analysis showed that Group K had smaller preoperative C7 slope than Group L (23.2°±10.3°, 31.6°±10.1°, respectively) (p < 0.05). From the receiver operator characteristic curve, the cut-off value was 26.5°, the sensitivity was 67.4%, and the specificity was 72.7%. Furthermore, the odds ratio was 9.3 (95%CI: 1.78-48.50, p < 0.01). No other preoperative factors affected postoperative kyphosis in our study: age, C2-7 Cobb angle, C2-7 sagittal vertical axis (SVA), center of gravity of the head-C7 SVA, and C7 short cervical length. Furthermore, the progression degree of kyphosis did not have correlation with each JOA recovery rate.</p><p>Conclusions: The risk factor of postoperative cervical kyphosis after laminoplasty for CSM was only a small preoperative C7 slope. The cut-off value of preoperative C7 slope was 26.5°.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 11 (5), 858-865, 2020-05-20

    The Japanese Society for Spine Surgery and Related Research

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