The severity of operative invasion to the posterior muscular-ligament complex influences cervical sagittal balance after open-door laminoplasty

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• 作者：Shengrong Lin ; Feifei Zhou ; Yu Sun ; Zhongqiang Chen…
• 关键词：Open ; door laminoplasty ; Cervical sagittal balance ; Muscular ; ligament complex
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：24
• 期：1
• 页码：127-135
• 全文大小：1,169 KB
• 参考文献：1. Chiba K, Ogawa Y, Ishii K et al (2006) Long-term results of expansive open-door laminoplasty for cervical myelopathy—average 14-year follow-up study. Spine (Phila Pa 1976) 31:2998-005 CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Purpose The aim of this study was to investigate how the severity of operative invasion to the posterior muscular-ligament complex impacts postoperative cervical sagittal balance. Materials and methods Ninety cases of open-door expansive laminoplasty due to cervical spondylotic myelopathy were reviewed. Fifty-three patients underwent laminoplasty with unilateral preservation of the muscular-ligament complex (unilateral elevation group). Thirty-seven patients underwent traditional open-door laminoplasty (bilateral elevation group). Preoperative and postoperative cervical sagittal parameters, including C2–C7 sagittal vertical axis (SVA), C0- Cobb angle and T1 slope, were compared. The cervical curvature, range of motion (ROM) and JOA score were also compared. Results The average follow-up time was 16.7?months (range 3-0?months). C2–C7 SVA significantly increased in the bilateral elevation group (+4.9?mm, P?=?0.005) but remained unchanged in the unilateral elevation group (?.2?mm, P?=?0.414). The C0- Cobb angle increased in both groups (+4.1°, P?P?=?0.002). The T1 slope also increased in both groups (+1.1°, P?=?0.015; +0.7°, P?=?0.042). The postoperative C3–C7 curvature significantly decreased in the bilateral elevation group (?.1°, P?P?P?P?P?=?0.001). The C0- Cobb angle was positively correlated with C2–C7 SVA (Pearson?=?0.303, P?=?0.004) and negatively correlated with the C3–C7 curvature (Pearson?=??.362, P? Conclusions Open-door laminoplasty significantly affected postoperative cervical sagittal balance, with the cervical vertebra appearing to tilt forward. As the severity of surgical invasion to the posterior muscular-ligament complex increased, the loss of cervical sagittal balance also increased.